EMT NREMT Study Guide v1
Using the rule of nines, what is the percentage of body surface area involved if there are burns on the chest and the anterior surface of one arm? 9% 13.5% 18% 27%
13.5%. Using the rule of nines, the anterior chest counts for 9%, and the anterior surface of a single arm would be 4.5%
Each attempt to suction a patient's airway should be limited to ___ seconds
15
The normal respiratory rate for a child is ___ breaths per minute
15 to 30
Normal breathing rate for children
15-30
normal breathing in kids
15-30 b/m
You and your partner Juan arrive on scene to a possible drowning. Coming through the back gate of the house you see two men doing CPR on a child of 8 or 9 years of age. When you begin CPR, what rate and depth of compressions will you use?
15:2 / one third the diameter of the chest
2 rescuer child/infant CPR
15:2 at 100 v/min
Type _ diabetes usually develops in adults and often is controlled by diet and oral medication.
2
compression technique
2 inches down over sternum
Flow rates for NRB
12-15 L/min
Normal breathing rate for adults
12-20
The normal respiratory rate for an adult is ___ breaths per minute
12-20
Ventilation rate for adults
12/min
Glucose after meal
120-140
You have observed your patient's chest rise and fall three times in 15 seconds. Therefore, the patient's respiratory rate is ___ per minute, which is considered ___ for an adult patient
12;normal
Children are considered adolescents between the ages of ___ and ___
13 to 18
Your patient is an unresponsive 44 year old female who has a pulse but is not breathing. How should you proceed with CPR
2 quick rescue breaths and then provide 10-12 breaths per minute
How long does angina pain last
2-15 min
How many shocks can I give
2-3 with CPR in-between
Albuterol: Dose
2.5 mg nebulized with 2.5 mL saline (for a total of 3mL)
Ventilation rate for children
20/min
Ventilation rate for infants
20/min
A 2 year old has one full leg burned and one full arm burned. What percentage of their body is considered burned?
22.5 percent
Critical incident stress debriefing is effective when it is conducted within ___ of the event.
24 to 72 hours
Normal breathing rate for infants
25-50
normal breathing in infants
25-50 breaths per minute
It is generally not necessary for the EMT to assess blood pressure in patients who are under ___ years of age
3
right vs left lung
3 lobes vs 2
The required amount of suctioning that a suction unit must provide.
30 L/min, 300 mmHg
When resuscitating a newborn, how often should heart rate be reassessed? 5 minutes 2 minutes 1 minute 30 seconds
30 seconds
If a patient is eight months pregnant, how much blood can she potentially lose before exhibiting signs of shock?
30-35%
1 rescuer child/infant CPR
30:2 at 100 ventilations/min
1-2 rescuer adult CPR
30:2 at 100 ventilations/min
ASA: Dosage
324mg (81mg x 4)
The spinal column is made up of _______ separate irregularly shaped bones called vertebrae
33
During cardiac arrest, organ damage can begin in ___ minutes
4 to 6
You are setting up the landing zone for a helicopter transport of a critical MVA patient. Which of the following would be considered acceptable methods of marking the boundaries of this zone?
4 vehicles with their lights pointed inward
The EMT should check the vital signs of an unstable patient at least every ___ minutes
5
When moving a patient you should try to keep the patient how many inches away from your body?
5-10 inches
health care directive
A written document that specifies medical treatment for a competent patient, should he or she become unable to make decisions. Also known as an advance directive or a living will.
tort
A wrongful act that gives rise to a civil suit.
What is an aneurysm?
An excessive localized enlargement of an artery caused by a weakening of the artery wall
Which method of penetrating injury would be considered low energy?
An ice pick stab
When communicating with patients you should do which of the following? Be aware of your body language Stand above the patient to convey authority Show emotion to demonstrate that you recognize how serious the situation is Avoid eye contact
Be aware of your body language
You have responded to the home of an 80-year-old female in cardiac arrest. The patient's husband states, "she doesn't want to be kept alive by machines." The husband is not able to produce a written document from the patient's physician verifying these wishes. What should you do?
Begin resuscitation.
What is an aortic arterial aneurysm (AAA)?
An abnormal enlargement or bulging of the aorta that causes sharp and tearing pain the abdomen that radiates to the back
channel
An assigned frequency or frequencies that are used to carry voice and/or data communications.
precedence
Basing current action on lessons, rules, or guidelines derived from previous similar experiences.
Your patient is a 70-year-old female who does not want you to take her blood pressure. You apply the blood pressure cuff causing the patient to become very upset. Which of the following terms describes your action? Battery Assault Negligence Duty to act
Battery
Distrust, jealousy, seclusiveness, and hostile, uncooperative behavior are all indications that your patient suffers from which of the following? Anxiety Depression Phobias Paranoia
Paranoia
bloodborne pathogens
Pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus and HIV
Pertinent negatives are often used when documenting patient conditions on a PCR. Which of the following is a pertinent negative for a patient experiencing an MI?
Patient denies chest pain
What are 3 physiological differences in the pediatric chest and abdomen?
Pediatrics have a softer chest wall, cannot breath as deep, and are abdominal breathers
The primary reason the EMT must use body substance isolation (BSI) or universal precautions is to:
Prevent the EMT from exposure to blood and bodily fluids that may contain potentially infectious material.
proximate causation
When a person who has a duty abuses it, and causes harm to another individual; the EMT, the agency, and/or the medical director may be sued for negligence.
Respiratory arrest
When breathing completely stops.
Secondary assessment
after immediate life- or limb-threatening injuries/illnesses have been identified, this more thorough evaluation is performed to identify more subtle, yet still important, injuries
pancreas
aids digestion by secreting juice that contains enzymes that help break down starches, fats and proteins. Releases amylase, bicarbonate and insulin
positive pressure ventilation vs normal ventilation
air can enter stomach through esophagus, blood is less inclined towards the heart (hypotension & decrease in cardiac output), more oxygen volume needed
anaphylactic shock treatment
airway, ventilations, oxygen, determine cause, assist w/ epi, transport
The general adaptation syndrome is characterized by which of the following phases?
alarm response, reaction and resistance, and recovery
The medication with which the EMT can assist the patient in respiratory distress is:
albuterol
hemophilia
body is not able to control bleeding by developing spontaneous clots as normal (mostly in males)
Falls are the most common cause of injury for which group of patients? Geriatric patients Pediatric patients Both geriatric and pediatric Middle-aged men
both geriatric and pediatric
The major artery of the arm
brachial artery
infant pulse check
brachial pulse
3 effects of intracranial pressure on vital signs
bradycardia, irregular breathing, hypertension
neurogenic shock signs/symptoms
bradycardia, low BP, signs of neck injury
amylase
break down starches into sugar. present in duodenum and saliva
Inhalation
breathing in
absence seizure
brief lapse of consciousness. patient unresponsive, staring. (petit mal)
Where would you must likely find information regarding a patient's wishes to be an organ donor?
driver's license
small intestine
duodenum, jejunum, ileum
Which of the following components are needed to prove negligence?
duty to act, breach of duty, injury/damages, and causation
pneumonia
dyspnea, chills/fever, cough, dark sputum, referred pain to upper abdomen
obstructive shock signs/symptoms
dyspnea, rapid/weak pulse, rapid/shallow breaths, decreased lung compliance, unilateral/decreased/absent breath sounds, decreased BP, JVD, tracheal deviation
fowlers position
ease breathing
A thrombus which has broken loose, moving with blood flow, is called an
embolism
occurs when an object migrates from one part of the body and causes a blockage of a blood vessel in another part of the body
embolism
caused by loss of elasticity of the lung tissue, from destruction of structures supporting the alveoli, and destruction of capillaries feeding the alveoli.
emphysema
mild airway obstruction
encourage to cough, give nonrebreathing oxygen
esophageal varices
enlarged and swollen veins at the lower end of the esophagus, signs of liver disease (fatigue, weight loss, jaundice, anorexia, edema in abdomen, abdominal pain, nausea, vomiting) gradual
The compliance monitoring component of an infection control plan should:
ensure that employees understand what they should do and why it is important..
You are dispatched to an office building for a 49-year-old male with chest pain. When you arrive at the scene, you find the patient to be conscious and alert, but in obvious pain. He tells you that he did not call 911; a coworker did. He further states that he does not want to be treated or transported to the hospital. You should:
ensure that he is aware of the risks of refusing medical care
The MOST important consideration at the scene of a hazardous material incident is:
ensuring your personal safety..
layers of skin, outside to inside
epidermis, dermis, subcutaneous
Red blood cell
erythrocyte
glucose levels above 200
excess glucose is excreted by the kidney (3 P's: polyuria, polydipsia, polyphagia)
polyphagia
excessive eating as a result of cellular hunger (only occasionally)
When performing his or her duties, the EMT is generally expected to:
exercise reasonable care and act prudently
You are assessing a middle-aged man with chest pain that you suspect is caused by a cardiac problem. The patient tells you that he does not want to go to the hospital and insists that you leave him alone. You should:
explain the seriousness of the situation to him, but avoid causing undue alarm.
shock position
increase blood flow to brain
Which of the following is the intended effect when administering sublingual nitroglycerin to a patient with a possible heart attack? lowered blood pressure increased oxygenation of the heart muscle decreased patient anxiety increased strength of heart contraction
increased oxygenation of the heart muscle
beta 1
increases HR, inotrophy (forced contraction of heart) increases electrical impulse in heart
Glucagon: Action
increases blood glucose by stimulating liver to release stored glycogen
While providing care to a patient, blood got onto the ambulance stretcher. Because the stretcher was not properly cleaned afterward, a virus was transmitted to another emergency medical technician (EMT) several days later. What route of transmission does this scenario describe?
indirect contact
Obtaining continuing medical education is the responsibility of the...?
individual EMT
Usually only _______ patients can develop hemorrhagic shock due to a closed head injury.
infant
Hepatitis B
infectious inflammation of the liver caused by the hepatitis B virus (HBV) that is transmitted sexually or by exposure to contaminated blood or body fluid
Hepatitis C
inflammation of the liver caused by the hepatitis C virus, transmitted by exposure to infected blood (rarely contracted sexually)
peritonitis
inflammation of the peritoneum, the serous membrane that surrounds the abdominal cavity and covers its organs, pain anywhere in abdominal area
gastroenteritis
inflammation of the stomach and intestines causes diarrhea or liquid stools, nausea, vomiting, fever, anorexia
sickle cell disease
inherited blood disorder of the RBC. oblong shape makes them poor oxygen carriers
As an EMT, it is important to remember that the signs and symptoms of cumulative stress:
may not be obvious or present all the time.
severe airway obstruction
heimlich maneuver for conscious adults and children chest thrust for pregnant women chest compressions for unconscious chest thrusts or back slaps for infants
sudden severe headache could be a sign of
hemorrhagic stroke
What deals with the well being of the EMT, career progression and EMT compensation?
human resources department
Hypoglycemia symptoms
hunger, fatigue, weakness, sweating, headache, dizziness, low bp, cold or clammy skin
conditions that mimic stroke
hypoglycemia (AMS), epidural/subdural bleeding (trauma), seizure postictal state (hemiparesis)
shock
hypoperfusion (inadequate circulation)
Glucagon: Side Effects
hypotension, nausea, vomiting, respiratory distress
The continuous quality improvement (CQI) process is designed to..:
identify areas of improvement and provide remedial training if needed
You and your partner are EMTs and have been dispatched to standby at the scene of a residential fire. While standing next to the ambulance observing the fire fighters, you see a woman frantically moving around in her burning house. You should:
immediately notify the incident commander or safety officer.
Which of the following is the MOST significant factor in determining if a person will become ill from certain germs?
immunity
Complex partial seizure
impairment of consciousness for a few min or less; usually has rhythmic movements of face or extremities
dyphasia
impairment of speech
Which of the following types of consent allows treatment of a patient who is unconscious or mentally incapacitated?
implied
epiglottitis
in acute form, a severe, life-threatening infection of the epiglottis and surrounding area that occurs most commonly in children between ages 2 and 12 (sit however is comfortable (supine could kill) don't use OPA)
uremia
inability to excrete waste from body bc of kidney failure. wastes remain in blood
expressive aphasia
inability to speak or speak clearly
receptive aphasia
inability to understand spoken or written words
cardiogenic shock cause
inadequate heart function, disease of muscle tissue, impaired electrical system, disease or injury
Hypoperfusion
inadequate perfusion also known as shock
obstructive shock causes
mechanical obstruction of the cardiac muscle causing a decrease in output (tension pneumothorax, cardiac tamponade)
Obstructive shock
mechanical obstruction or compressing that prevents blood from reaching the heart
The EMT's scope of practice within his or her local response area is defined by the:
medical director
The person who is responsible for authorizing EMTS to perform emergency medical care in the field is the?
medical director
Petit mal
milder form with loss of consciousness for a few seconds. Common in children. May disappear by late adolescence
the amount of air breathed in during each respiration multiplied by breaths/minute
minute volume
Which of the following is considered a significant mechanism of injury? falling from a curb onto the street 15 mph vehicle collision stab wound to the hand motorcycle collision
motorcycle collision
Heat cramp
muscle pain or spasm due largely to the loss of salt from the body from sweating, or inadequate intake of salt
Am example of a generalized seizure is:
muscle spasms over the entire body in an unresponsive patient.
diaphragm
muscular partition that separates the thoracic cavity from the abdominal cavity and aids in respiration by moving up and down
kidneys
regulation of acidity and BP. Remove sodium chloride from body & excess fluid. Rid body of toxic wastes and control balance of fluid and electrolytes
beta 2
relaxes smooth muscle such as bronchioles and some vessels
While assisting an advanced life support (ALS) ambulance crew, you are accidentally stuck with an IV needle. You should:
report the incident to your supervisor after the call.
spleen
solid organ in left upper quadrant // processes blood (filters out worn out cells, foreign substances and bacteria)
ileum
soluble molecules are absorbed into the blood. proteins, fats and starches are reduced to amino acids, fatty acids and simple sugars
Seizure
sudden, transient disturbances in brain function resulting from abnormal firing of nerve impulses (may or may not be associated with convulsion)
Prior to delivery, if the mother is in the supine position, she may develop dizziness and a drop in blood pressure. This is called:
supine hypotensive syndrome
Distention
swelling
edema
swelling
hemorrhoids
swelling and inflammation of blood vessels surrounding the rectum. bright red blood during defecation, itching
aneurysm
swelling or enlargement of part of an artery resulting from weakening of the arterial wall
Which of the following infectious diseases confers no protection from reinfection after exposure?
syphilis
NTG: Contraindications
systolic pressure <100mm/Hg, use of ED med within last 24 hrs, head injury
mallory-weiss syndrome
tear in the distal esophagus from retching in alcoholism or bulimia, vomiting = principal syndrome. extreme blood and fluid loss possible. signs of shock
While on duty, your partner asks you out on a date and touches you in an inappropriate location without your consent. You should:
tell your partner to stop and report the incident to your supervisor.
psychogenic (fainting) shock cause
temp/generalized vascular dilation, anxiety, bad news, sign of blood, severe pain, illness, tiredness
seizure
temporary alteration in consciousness
Epidural hematoma
temporoparietal skull fracture; tear middle meningeal artery
thrombophilia
tendency to develop blood clots
When air continues to enter the chest after a lung has collapsed and begins to compress the other lung, this condition is which of the following? Pneumothorax tension pneumothorax pericardial tamponade sucking chest wound
tension pneumothorax
According to the CDC, recommended immunizations and tests include a:
tetanus-diphtheria booster every 10 years.
In the eyes of the court, an incomplete or untidy patient care form indicates:
that inadequate patient care was administered
cerebellum
the "little brain" attached to the rear of the brainstem; its functions include processing sensory input and coordinating movement output and balance
vertebrae
the 33 bones of the spinal column
Right date, right patient, right drug, right dose, right route
the 5 rights
In which of the following circumstances can the EMT legally release confidential patient information?
the patient is competent and signs a release form
Bloody show
the pink-tinged secretions that follow the loss of the mucous plug b/c of exposed cervical capillaries. this is a sign that labor will begin within 24-48 hours.
EMRs such as fire fighters, law enforcement officers and park rangers are an integral part of the EMS system because...?
the presence of a person training to initiate basic life support (BLS) care cannot be ensured
Non urgent move
No immediate threat to life, are carried out in such a way as to prevent injury and to avoid discomfort and pain.
Your patient is complaining of shortness of breath and is using accessory muscles to breathe, but is maintaining her own airway and moving an adequate amount of air. You should provide oxygen via:
Non-rebreather mask
You arrive on the scene of a motor vehicle collision. Your patient is conscious and has normal vital signs, but complains of back pain. You should move this patient using which move?
Nonurgent
Which of the following statements regarding the hepatitis B vaccine is correct?
OSHA requires that your employer offer you the vaccine free of charge.
Cyanosis can often ____________.
Occur with hypoxia
hemorrhagic stroke
Occurs as a result of bleeding within the brain. Forms a clot, which squeezes the brain tissue. (ppl w/ very high BP-- exertion or stress)
Heat exhaustion
Occurs when the body's cooling mechanism have been expended Skin is normal to cool in temp Pale or Gregory in color And sweaty
As an EMS provider, working within written protocols is an example of:
Off-line medical control.
anterior
Toward the Front
posterior
Toward the back
dorsal
Toward the back/spine
ventral
Toward the front/ belly
Glucagon
a hormone secreted by the pancreas
internal respiration
..., exchange of gases between the blood and the cells of the body
external respiration
..., exchange of gases between the lungs and the blood
aed shock then pulse check?
No aed shock then 2min CPR then pulse check
Blunt force trauma
No cut but internal problem
Whose safety is the highest priority on any EMS call?
The EMS crew
tachypnea
..., fast breathing, an abnormally rapid rate of respiration, usually >20 breaths per minute
nasopharyngeal
..., flexible airway inserted through the patients nose
In the management of a seizure patient, attention should be focused on all of the following except:
CPR
Which of the following statements is MOST consistent with the bargaining phase of the grieving process?
"I will be compliant with all my medications if I can just see my grandson graduate.".
Which of the following statements would NOT be appropriate to say to the family of a dying patient?
"Things will get better in time."
Common questions asked by patients with a serious illness or injury include all of the following, EXCEPT:
"What hospital am I going to?"
Flexion posturing
(Formerly known as decorticate posturing). Client flexes one or both arms on the chest and may extend the legs stiffly. Indicates nonfunctioning cortex. Lesions of cerebral hemispheres or internal structures of brain cause this posturing.
upper airway
(Nose, mouth, pharynx, larynx)FUNCTION:*Conducts air to lower airway *Protects lower airways *Warms, filters & humidifies air
cholecystitis
(gallstone blockage) inflammation of gallbladder, right upper quadrant pain and right shoulder
generalized seizure
(grand mal) characterized by unconsciousness and generalized severe twitching all body muscles resulting from abnormal discharges from large areas of the brain
alkalosis
(lack of acids) causes symptoms of hyperventilation syndrome: dizziness, numbness, tingling, anxiety
Para
(obstetrics) the number of live-born children a woman has delivered
Hollow organs
-stomach, small intestine, colon, bladder, gallbladder
If a mask cannot be placed on a coughing patient, the Centers for Disease Control and Prevention (CDC) recommend that you maintain a distance of at least ________ feet if possible.
. 3
tonsil tip
... Rigid suction
oropharyngeal
..., -curved plastic device used to establish an airway in a patient by displacing the tongue from the posterior wall of the oropharynx -used in unconscious patients who do not have a gag reflex
cyanosis
..., A bluish discoloration of the skin and mucous membranes
crowing
..., A breathing sound similarto the cawing of a crow; may indicate that muscles around the larynx are in spasm.
patent airway
..., An airway that is open and clear of obstructions.
n-95
..., Mask used for a patient with TB
pulmonary ventilation
..., Movement of air into and out of the lungs
retractions
..., Movements in which the skin pulls in around the ribs during inspiration.
intercostal muscles
..., Muscles which move the rib cage during breathing
cricoid pressure
..., Pressure on the trachea, prevents air from entering the esophagus/stomach and vomiting
agonal respiration
..., Shallow, slow or infrequent breathing
respiratory arrest
..., When breathing completely stops.
respiratory failure
..., a condition in which the level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high
stridor
..., a whistling sound when breathing (usually heard on inspiration) upper airway
rales
..., abnormal crackling sound made during inspiration
True or false: concerning radio communication, you should use the patient's first and last name.
False
True or false: the most efficient type of cellular metabolism is anaerobic metabolism
False
True or false: the use of an emergency vehicle escort is highly recommended when transporting critical patients.
False
Supine hypertensive syndrome
Pressure on the vena cava by baby when mother is in supine position
UHF (ultra-high frequency)
Radio frequencies between 300 and 3,000 MHz.
less than 13
Rapid transport (what's the number on the GCS)
Secondary assessment for trauma major injury
Rapid trauma assessment Vitals Sample
snoring sounds
..., airway blocked, open patients airway promt transport
dyspnea
..., difficult or labored respiration
Secondary assessment for medical unresponsive
Rapid trauma assessment Vitals Sample
FROPVD
..., flow-restricted, oxygen-powered ventilation device: a device that uses oxygen under pressure to deliver artifical ventilations. Its trigger is placed so that the rescuer can operate it while still using both hands to maintain a seal on the face mask. Has automatic flow restriction to prevent overdelivery of oxygen to the patient.
gurgling
..., indicates presence of fluid in the upper airway, need for suctioning
visceral pleura
..., inner layer of pleura that surrounds each lung
rhonchi
..., lower-pitched sounds like snoring or rattling, secretions in larger airways (pneumonia, bronchitis, aspiration)
pleura
..., membrane surrounding the lungs
parietal pleura
..., pleura that lines the inner chest walls and covers the diaphragm
cellular respiration
..., process that releases energy by breaking down glucose and other food molecules in the presence of oxygen
bradypnea
..., slow respiratory rate, usually below 10 respirations per minute
bronchioles
..., smallest branches of the bronchi
capillary refill
..., tested by pressing the nail tip briefly and watching for color change. A normal finding is the pink tone returns immediately when pressure is released. An abnormal finding is slow (greater than 2 seconds) return of pink tonewith respiratory or cardiovascular diseases that cause hypoxia.
respiration
..., the bodily process of inhalation and exhalation
carina
..., the fork at the lower end of the trachea where the two mainstem bronchi branch.
pleural space
..., the small potential space between the parietal and visceral layers of the pleura
methods of artifical ventilation
...Mouth to mask Two person bag valve Fropvd One person bag valve
french tip
...Soft suction
Epinephrine: Dosage Epi-Pen =
0.3mg, Epi-Pen Jr = 0.15mg (for <60 lbs)
NTG: Dosage
0.4mg SL, repeat every 3-5 min for 15 min
Atrovent: Dose
0.5 mg nebulized w/ 2.5 mL saline (3mL total)
Type _ diabetes usually develops in childhood, and requires at least daily doses of supplemental insulin.
1
child/infant ventilation rate
1 breath every 3 to 5 seconds
adult ventilation rate
1 breath every 5-6 second
Activated Charcoal: Dosage
1 g/kg of body weight, adults usually 25-50g, children 12.5-25g
Exercise and heat can work together to cause the loss of ___ of perspiration per hour: 50ml 500ml 1 liter 2 liters
1 liter
Laypeople can perform what skills?
1) control of life threatening bleeding
Three stages of labor
1) dilation 2) expulsion 3) placenta
In an adult patient, the loss of how much blood is considered serious? 500ml 1,000ml 1500ml 2,000ml
1,000ml
Flow rates for nasal cannula
1-6 L/min
nasal canula
1-6 L/min, 24- 44% oxygen
normal breathing in adults
10-20 b/m
normal infant pulse
100-160
Stages of shock
1. Compensatory Shock 2. Decompensatory Shock 3. Irreversible Stage
A sudden loss of _______ of blood is considered serious in an average adult.
1000cc
The normal respiratory rate for adults is ___ breaths per minute
12 to 20
anatomical planes
1. coronal (vertical cut into front and back halves) 2. transverse (horizontal cut into upper and lower) 3. sagittal (vertical cut into left and right halves)
Glucagon: Dosage
1.0 mg for >44lbs, 0.5 mg for <44lbs, repeat in 20 min if no response
infant (1 month-1 year) depth
1.5 inches (adult and children = 2 or 1/3 of chest)
nonrebreathing mask
10-15 L/min up to 90% oxygen
You are assessing a 6 month old infant girl and become concerned when you discover her respiratory rate. Which of the following rates would give you this concern?
: 60 breaths/min
foodborne transmission
The contamination of food or water with an organism that can cause disease.
Which of the following patient situations should be considered a high priority for expedited transport? 30-year-old female in active labor with her first child 3-month-old infant with a fever and a rash 50-year old male who is alert but complaining of chest pain 45-year old female with nausea and vomiting
50-year old male who is alert but complaining of chest pain
Approximately how much blood can an adult lose and still not be harmed?
500 mL
Bleeding of up to how much is normal following delivery? 100ml 500ml 1000ml 1500ml
500ml
adult/child blood in body
6 L / 2-3 L
Resuscitative measures should be implemented if a newborn's heart rate is less than which of the following? 60 70 80 100
60
Pulse rates for school-aged children should range between which of the following? 40 and 80 60 and 110 80 and 120 90 and 130
60 and 110
Normal diastolic BP in adults
60 to 90
normal adult pulse
60-100
Normal pulse rate for an adult
60-100 bpm
spinal column
7 cervical spine, 12 thoracic (w/ ribs), 5 lumbar, 5 fused sacrum, 4 fused coccyx
A critical incident stress debriefing should be conducted no longer than ________ hours following the incident.
72
If the patient is not defibrillated within _______ minutes of a cardiac arrest, there is almost no chance for survival.
8
Normal glucose
80-120
Glucose after 8-10hr of no food
80-90
One minute after the complete delivery of an infant, his fingers and toes are bluish in color, the heart rate is 140, his arms and legs are flexed, and he is crying. The APGAR score is which of the following? 7 8 9 10
9. In this case, the infant only loses 1 point for appearance due to cyanosis of the fingers and toes, which is typical immediately following birth.
When a patient's body temperature drops below ______, he or she will stop shivering. This is a sign of _________________.
90 degrees / severe hypothermia
What temp and humidity are bad for the body to regulate temp
90 degrees and 75 humidity
Normal systolic BP in adults
90 to 150
In an adult, a systolic BP of __ or less is hypotensive
90mmHg
Oximeter reading in a normal, healthy person
96-100
oxygen saturation of hemoglobin in body
96-100% of hemoglobin
normal skin temp
98.6
You are assessing a patient who is complaining of severe chest pain. They are sweating and their BP is 96/55. You have their medications with you and they include a prescription for nitroglycerin. You contact medical control and they order you to give the patient 1 nitro tablet sublingually. What would you do?
: Repeat the blood pressure and ask again what they would like you to do
You and your partner Chin have been called to an apartment complex on the wrong side of the tracks. The reporting party said her husband was not acting normally and has been complaining of chest pain for a week. She said he would not go to the hospital even after repeated requests from her to do so. You enter the dark apartment to find a man in his 70's lying back in a recliner. He has a GCS of 7 and is breathing shallow at 26 breaths per minute. You cannot find a pulse. What would be the best course of action?
: Secure his airway and begin assisting ventilations
hypoxic drive
A "backup system" to control respiration; senses drops in the oxygen level in the blood.
pulmonary embolism
A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow. Symptoms: light-headedness, dyspnea (labored breathing), tachypnea (rapid breathing), hypoxia, cyanosis, hemoptysis (coughing up blood)
thromboembolism
A blood clot that has formed within a blood vessel and is floating within the bloodstream.
What is sepsis? What can cause it?
A blood infection Causes: vasodilation, which then can cause shock from a lack of perfusion
What is Coumadin?
A blood thinner
morality
A code of conduct that can be defined by society, religion, or a person, affecting character, conduct, and conscience.
acute abdomen
A condition of sudden onset of pain within the abdomen, usually indicating peritonitis;
What is coronary artery disease?
A condition that narrows or blocks arteries of the heart
posttraumatic stress disorder (PTSD)
A delayed stress reaction to a prior incident. This delayed reaction is often the result of one or more unresolved issues concerning the incident.
communicable diseases
A disease that can be spread from one person or species to another.
What is osteoporosis? A type of cancer A type of splint A disease that causes bones to become brittle The outer layer of the bones
A disease that causes bones to become brittle
atherosclerosis
A disorder in which cholesterol and calcium build up inside the walls of the blood vessels, forming plaque, which eventually leads to partial or complete blockage of blood flow.
Low velocity injuries
A knife or other impailed object in the body exerts damage to the immediate area of impact and it's underlying structures. The length of the object used is important
contributary negligence
A legal defense that may be raised when the defendant feels that the conduct of the plaintiff somehow contributed to any injuries or damages that were sustained by the plaintiff.
cellular telephone
A low-power portable radio that communicates through an interconnected series of repeater stations called "cells."
An infant or child patient who exhibits wheezing, increased breathing effort on exhalation, or rapid breathing without stridor probably has:
A lower-airway disease
Which of the following situations is most clearly a behavioral emergency? A woman calls for an ambulance to take her son to a drug rehabilitation program because he smokes marijuanna. A man calls 911 because his mother, who has Alzheimer's disease, is wandering through the house late at night disturbing other family members and is being uncooperative. A patient with a history of depression calls for an ambulance because she has a severe headache. Any call for a patient with a history of mental illness is considered a behavioral emergency.
A man calls 911 because his mother, who has Alzheimer's disease, is wandering through the house late at night disturbing other family members and is being uncooperative.
infectious disease
A medical condition caused by the growth and spread of small, harmful organisms within the body.
Stroke
A medical injury to brain that is not related to truma
duty to act
A medicolegal term relating to certain personnel who either by statute or by function have a responsibility to provide care.
Shortly after loading your patient, a 50-year-old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. He is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. Which of the following statements regarding this situation is correct?
A mentally competent adult can withdraw his or her consent to treat at any time
pathogen
A microorganism that is capable of causing disease in a susceptible host.
noepinephrine
A neurotransmitter from nerve endings and a hormone from the adrenal gland. It is release in times of stress and is involved in hunger regulation, blood glucose regulation and other body processes.
In which of the following situations should an EMT use an emergency move? A patient with difficulty breathing who has been involved in a vehicle collision A patient who is unresponsive in her home due to carbon monoxide poisoning A patient with a fever who must be moved from her bed A patient who has fallen in her front yard and who is screaming at you to get her inside before her neighbors see her
A patient who is unresponsive in her home due to possible carbon monoxide poisoning
postictal state
A period following a seizure that lasts between 5 and 30 minutes; characterized by labored respirations and some degree of altered mental status
emancipated minors
A person who is under the legal age in a given state but, because of other circumstances, is legally considered an adult.
Standing Orders
A policy or protocol issued by a Medical Director that authorizes EMT-Bs and others to perform particular skills in certain situations.
Extension posturing
A posture in which the pt arches the back and extends the arms straight out parallel to the body. A sign of serious head injury
certification
A process in which a person, an institution, or a program is evaluated and recognized as meeting certain predetermined standards to provide safe and ethical care.
telemetry
A process in which electronic signals are converted into coded, audible signals; these signals can then be transmitted by radio or telephone to a receiver with a decoder at the hospital.
critical incident stress management (CISM)
A process that confronts the responses to critical incidents and defuses them, directing the emergency services personnel toward physical and emotional equilibrium.
Which of the following statements regarding a patient with a behavioral crisis is correct?
A quiet patient is not as likely to attack you as one who is screaming..
scanner
A radio receiver that searches or "scans" across several frequencies until the message is completed; the process is then repeated.
emergency
A serious situation, such as injury or illness, that threatens the life or welfare of a person or group of people and requires immediate intervention.
The EMS medical director can what to an EMT's scope of practice?
An EMT's scope of practice may be expanded by the medical director after proper training and state approval
repeater
A special base station radio that receives messages and signals on one frequency and then automatically retransmits them on a second frequency.
dedicated line
A special telephone line that is used for specific point-to-point communications; also known as a "hotline."
The autonomic nervous system is _____________.
A subdivision of the peripheral nervous system
Rule of nines
A system that assigns percentages to sections of the body, allowing calculation of the amount of skin surface involved in the burn are, a method of estimating the extent of a burn. For an adult, each of the following surfaces represents 9% of the body surface: the head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity. The remaining 1% is assigned to the genital region. For an infant or child the percentages are modified so that 18% is assigned to the head, 14% to each lower extremity.
medicolegal
A term relating to medical jurisprudence (law) or forensic medicine.
negligence per se
A theory that may be used when the conduct of the person being sued is alleged to have occurred in clear violation of a statute.
rapport
A trusting relationship that you build with your patient.
durable power of attorney for health care
A type of advance directive executed by a competent adult that appoints another individual to make medical treatment decisions on his or her behalf in the event that the person making the appointment loses decision-making capacity.
health care proxies
A type of advance directive executed by a competent adult that appoints another individual to make medical treatment decisions on his or her behalf in the event that the person making the appointment loses decision-making capacity. Also known as a durable power of attorney for health care.
expressed consent
A type of consent in which a patient gives express authorization for provision of care or transport.
Tension pneumonthorax
A type of pneumothorax in which air can enter the pleural space but cannot escape via the route of entry. This leads to increased pressure in the pleural space, resulting in lung collapse. The increase in pressure also compresses the heart and vena cavae, which impairs circulation.
cover and concealment
The tactical use of an impenetrable barrier for protection
Which of the following statements regarding a patient refusal is MOST correct? A. A mentally competent adult has the legal right to refuse EMS care and transport. B. Advice given to a patient who refuses EMS treatment should not be documented. C. A patient who consumed a few beers will likely be able to refuse EMS treatment. D. Documentation of proposed care is unnecessary if the patient refuses treatment.
A. A mentally competent adult has the legal right to refuse EMS care and transport.
Which of the following statements regarding standing orders is MOST Correct? A. Standing orders should be followed when physician contact is not possible. B. Standing orders have less legal authority than orders given via radio. C. Standing orders require you to contact medical control first. D. Standing orders only highlight the care that you may provide.
A. Standing orders should be followed when physician contact is not possible.
Information included in a radio report to the receiving hospital should include all of the following, EXCEPT: A. a preliminary diagnosis of the patient's problem. B. your perception of the severity of the problem. C. a brief summary of the care you provided. D. a brief history of the patient's current problem.
A. a preliminary diagnosis of the patient's problem.
A patient's refusal for EMS treatment and/or transport must be: A. an informed refusal. B. reported to the police. C. authorized by a judge. D. witnessed by a notary.
A. an informed refusal.
When relaying patient information via radio, communications should be: A. brief and easily understood. B. spoken in a loud voice. C. lengthy and complete. D. coded and scripted.
A. brief and easily understood.
Communicating with hearing-impaired patients can be facilitated by doing all of the following, EXCEPT: A. elevating the tone of your voice and exaggerating word pronunciation. B. shining a light on your face when you are in a darkened environment. C. providing pen and paper if the patient prefers to write his or her response. D. placing yourself in a position to ensure that the patient can see your lips.
A. elevating the tone of your voice and exaggerating word pronunciation.
When obtaining patient care orders from a physician via a two-way radio, it is MOST important to remember that: A. his or her instructions are based on the information you provide. B. all orders should be carried out immediately and without question. C. the physician may or may not be located within your service area. D. the use of 10 codes is an effective method of communication.
A. his or her instructions are based on the information you provide.
Two-way communication that requires the EMT to "push to talk" and "release to listen" describes what mode of communication? A. simplex B. multiplex C. mediplex D. duplex
A. simplex
After being dispatched on an emergency call, you should expect the dispatcher to provide you with all of the following information, EXCEPT: A. the general geographic location of the incident. B. the time at which your unit was dispatched. C. other agencies that are responding to the scene. D. the number of patients involved in the incident.
A. the general geographic location of the incident.
General guidelines for effective radio communications include all of the following, EXCEPT: A. using 10 codes to ensure radio traffic confidentiality. B. acknowledging a transmission as soon as possible. C. speaking in a clear, calm, monotone voice. D. holding the microphone about 2" to 3" from your mouth.
A. using 10 codes to ensure radio traffic confidentiality.
What skill or intervention is included at every level of prehospital emergency training?
AED
obstructive shock treatment
ALS assist and/or rapid transport
complex partial seizure
AMS from abnormal discharges from the temporal lobe of the brain. Lip smacking, eye blinking, isolated convulsions or jerking of body or one part of the body such as an arm. May experience bad smells, visual hallucinations, fear, repetitive physical behavior.
You just transported a patient with an injured ankle to the emergency department and placed her in a wheelchair in the waiting room, without talking to a nurse or leaving a report. Which of the following terms describes your action? Breach of contract Negligence Abandonment Assault
Abandonment
decision-making capacity
Ability to understand and process information and make a choice regarding appropriate medical care.
competent
Able to make rational decisions about personal well-being.
When lifting a patient, it is best if your partner is which of the following? About as strong as you are Stronger than you are Not as strong as you are Any of the above, as long as you both use proper body mechanics
About as strong as you are. It is best because it is good to maintain balance.
While walking into a grocery store you notice a young mother violently shaking her 14-month-old child and telling it, "Shut up!" If you were to respond to her residence later in the day and find the child unresponsive, what possible injuries could you expect to find?
Acceleration-deceleration injuries to the cervical spine A fracture to the forearm Hemorrhaging of the retina
What are 4 signs and symptoms of inadequate breathing in children?
Accessory muscle use, seesaw breathing, super clavicular retraction, grunting
___ ___ is usually caused by viruses or bacteria and may last several days or weeks.
Acute bronchitis
Albuterol: Indications
Acute bronchospasm due to asthma or COPD
Pertussis
Acute infectious disease characterized by a cough that has a "whoop" sound; also called whooping cough
A young man with difficulty breathing has emptied one of his inhalers and is attempting to use a second inhaler. He is still wheezing. He is also shaking and cannot guide the inhaler to his mouth on his own. His blood pressure is 130/90, heart rate is 112, and respirations are 28. You should: Assist the patient with the second inhaler administer oxygen by nonrebreather mask both a and b none of the above
Administer oxygen by nonrebreather mask
Self destructive behavior typically begins in what age group?
Adolescence
MOI falls
Adults 20 feet children/infants more than 10 feet or 2or3 times their height
As compared to an adult, the child's airway is different in that the:
Airways are proportionally narrower
Respiratory distress is indicated by which examination finding? Nasal flaring sternal or intercostal retraction wheezing all of the above
All of the above
The EMS report form is best described as which of the following? A legal document A part of the patient's medical record An educational tool All of the above
All of the above
battery
Touching a patient or providing emergency care without consent.
The potential for airway obstruction is compounded in infants and children by which of the following? Smaller airways easily blocked by secretions. A proportionally larger tongue. A large head causing hyperextension when supine. All of the above.
All of the above
What should the narrative portion of the report include? Description of how the patient was found Treatments given Assessment findings All of the above
All of the above
Which of the following best explains the role of defibrillation in the treatment of children? Children require smaller defibrillation pads and less energy than adults Defibrillation is rarely indicated in children Automated defibrillators are typically not designed for use in children All of the above
All of the above
Which of the following is a contraindication to the use of an AED? The patient responds to painful stimuli The patient has a pulse The patient is breathing All of the above
All of the above
Which of the following is an important personal attribute of EMTs? Being informed about local, state, and national issues in EMS Maintaining a neat, clean, positive image Placing the patient's needs above all else, except personal safety All of the above
All of the above
Which of the following is an indication that violent behavior may occur? Yelling or screaming Use of profanity Clenched fists All of the above
All of the above
Which of the following is true of the respiratory system of infants and small children, compared to that of adults? The tongue is proportionally larger The trachea is soft and flexible The airways are smaller All of the above
All of the above
Which of the following provides information on hazardous materials? NFPA 704 Labels U.S. DOT-approved placards material safety data sheets All of the above
All of the above
Which of the following signs would you expect to see in a patient with ongoing blood loss? increased heart rate increased respiratory rate cool, pale skin all of the above
All of the above
You are caring for a patient who is having a seizure. His family states he has never had a seizure before. Which of the following questions can provide important information? Has the patient recently suffered an injury to the head? Has the patient ever suffered an injury to the head? Has the patient been ill? All of the above
All of the above
You are inside a vehicle providing care to an entrapped patient. Which of the following pieces of personal protection equipment is required? Helmet Safety glasses or goggles Structural firefighting or bunker gear All of the above
All of the above
You are on the scene of a motor vehicle collision. Your patient, a 50-year-old male, is out of the vehicle and sitting on the ground. When you approach him he throws a rock at you and screams that you better not get near him. Which of the following should you assume to be the cause of the patient's behavior? Psychiatric illness Hypoxia hypoglycemia all of the above
All of the above
You respond to the scene of an adult patient who was injured when she was thrown from a horse. The patient is complaining of neck pain, but refuses to be immobilized. The EMT explains the risks to the patient, but she still refuses. At the the emergency departments, a nurse threatens to report the EMT for negligence. Fortunately the patient does not have a serious injury. Which of the following necessary components to prove negligence is missing? Breach of duty Infliction of injury A causal link between the EMT's actions and the patient's injury All of the above
All of the above
Your patient is a motorcyclist who struck the side of a car and was ejected. Which of the following would be a reason to remove her helmet? The helmet interferes with airway management The helmet prevents proper immobilization of the spine The helmet interferes with assessment of an injury All of the above
All of the above
Your patient's family feels he may be at risk for suicide. Which of the following would increase this risk? The patient has been charged with burglary and is awaiting trial. The patient's girlfriend broke up with him. The patient has previously attempted suicide. All of the above
All of the above.
Albuterol: Contraindications
Allergy
Atrovent: Contraindications
Allergy to drug, soybeans, peanuts, glaucoma
Which of the following best describes the action of insulin? Increases the level of sugar in the blood Stimulates the pancreas Allows sugar to enter the cells for energy Breaks down fats for use as energy
Allows sugar to enter the cells for energy
alpha1 and Alpha2
Alpha1 vessels constrict and release sweat Alpha2 try's to regulate alpha1
hypo perfusion
Also known as shock (decreased blood flow through an organ, as in hypovolemic shock; if prolonged, it may result in permanent cellular dysfunction and death.)
What are 5 signs and symptoms of diabetic ketoacidosis?
Altered mental status, acetone breath, thirst, nausea, hard time breathing
What are 4 signs of increased intracranial pressure?
Altered mental status, increased BP, decreased HR, unequal pupils
What are the 9 signs and symptoms of anaphylaxis? What is the treatment?
Altered mental status, nausea, vomiting, pale, cool, clammy, increased pulse, increase respiration rate, decreased blood pressure Treatment: manage abc's, provide O2, epinephrine
residual volume
Amount of air remaining in the lungs after a forced exhalation
Which of the following scenarios MOST accurately depicts a posttraumatic stress disorder (PTSD) reaction?
An EMT becomes distracted at the scene of a motor vehicle crash involving the same type of car in which a child was previously killed.
ischemia
An inadequate blood supply to an organ or part of the body, esp. the heart muscles.
Epinephrine: Indications
Anaphylaxis
What is anemia? What can cause it?
Anemia is low red blood cell count Caused by bleeding
You just informed a family that their loved one is dead and that there is nothing you can do for her. The patient's son screams at you and punches the wall. This is best described as
Anger, which is to be expected in response to death of a loved one.
You are treating A critically injured child. The child's mother is crying and saying, "Please, God, let him live. I swear I will never ask for anything again." Which term best describes the mother's reaction?
Bargaining
What are 5 signs of congestive heart failure (CHF)?
Anxiety, dyspnea, pedal and sacral edema, diminished lung sounds, rales
protected health information (PHI)
Any information about health status, provision of health care, or payment for health care that can be linked to an individual. This is interpreted rather broadly and includes any part of a patient's medical record or payment history.
base station
Any radio hardware containing a transmitter and receiver that is located in a fixed place.
noise
Anything that dampens or obscures the true meaning of a message.
Oxygenated blood leaving the heart first enters which blood vessel?
Aorta
What is the largest artery in the body?
Aorta
APGAR
Appearance, pulse, grimace, activity, respiratory effort
Which is the primary method of bleeding control? A tourniquet Use a pressure point Apply direct pressure Application of ice
Apply direct pressure
Tertiary phase injuries
Are due to being throw and then landing on the ground similar to being ejected out of a car
Secondary phase injuires
Are due to flying debris propelled by the blast They are usually lacerations fracture burns
Primary phase injuries
Are due to the pressure wave of the blast. Injuries primarly effect the gas-containing organs, such as the lungs, stomach, intestines, inner ears and sinuses. Death may occur from this stage w/o any sign of external injury
As you are wheeling your patient through the emergency department doors, you receive a/anther call for a major motor vehicle crash. You should: A. place the patient in a high-visibility area and then respond to the call. B. respond only after giving a verbal patient report to a nurse or physician. C. leave a copy of the run form with a nurse and then respond to the call. D. inform the admissions clerk of the situation and then respond at once.
B. respond only after giving a verbal patient report to a nurse or physician.
You arrive on scene with your partner Leonard to the report of a child appearing lethargic. Upon entering the house, you see a 9-year-old girl lying on the couch. Her father says she has been breathing strangely and began vomiting about 45 minutes ago. During your assessment, you determine she needs to be transported to the ER immediately. Which of the following sets of vitals would lead you to believe this girl is in need of immediate transport?
BP 100/58, respirations of 14 per minute and a pulse of 130
A barrel chest appearance is assosciated with:
COPD
You have been called to an office building for a person "acting strangely." According to coworkers the 40-year-old woman seemed confused and "shaky," looked pale, and then began sweating profusely. On your arrival the patient is swearing and uncooperative with a coworker who is trying to get her to sit down. The coworkers state that this is very uncharacteristic of the woman, with whom they have worked for 12 years. Which of the following should be determined first? Ask whether the patient has a history of diabetes Ask if the patient has a history of depression See if something has happened to upset the patient Ask if the patient has threatened to hurt herself or anyone else
Ask whether the patient has a history of diabetes
Common diseases from rhonchi
Aspiration Pneumonia Emphysema Chronic bronchitis
The purpose of a system of emergency medical services is to care for sick and injured patients by providing:
Assessment, transportation, and stabilization. Definitive care is not given in the prehospital setting.
Common diseases from wheezing
Asthma Emphysema Chronic bronchitis
Where do most collisions involving ambulances occur? On interstates With oncoming traffic At intersections On two-lane roads
At intersections
EMTs should be trained to which level for hazardous materials? Awareness Operations Technician Specialist
Awareness
lateral
Away from center of body
Which of the following statements regarding communication with a child is MOST Correct? A. Give the child minimal information to avoid scaring him or her. B. Standing over a child often increases his or her level of anxiety. C. Most children are intrigued by strangers wearing uniforms. D. Unlike adults, children cannot see through lies or deceptions.
B. Standing over a child often increases his or her level of anxiety.
When you begin an oral report, you should state the patient's age, sex, and: A. any known allergies. B. chief complaint. C. the emergency care given. D. past medical history.
B. chief complaint.
During the alert and dispatch phase of EMS communications, the dispatcher's responsibilities include all of the following, EXCEPT: A. screening and assigning a priority to each call based on local protocols. B. discouraging the caller from providing care until the EMS unit arrives. C. selecting and notifying the Correct EMS response units and personnel. D. coordinating responding EMS units with other public safety personnel.
B. discouraging the caller from providing care until the EMS unit arrives.
You are dispatched to the residence of an Asian family for a child with a high fever. When you assess the child, you note that he has numerous red marks on his back. The child's parents explain that these marks represent coining—a traditional Asian healing practice in which hot coins are rubbed on the back. You should: A. acknowledge and respect this practice as a cultural belief, but advise the child's parents that it has no healing power. B. document this on your patient care report and advise the emergency department staff of what the child's parents told you. C. advise the child's parents that this is a harmful practice and is considered a form of child abuse in the United States. D. advise the emergency department physician that you feel as though the child was intentionally abused by his parents.
B. document this on your patient care report and advise the emergency department staff of what the child's parents told you.
A ___________ receives messages and signals on one frequency and then automatically retransmits them on a second frequency. A. decoder B. repeater C. scanner D. duplex
B. repeater
Emphysema, chronic bronchitis, and many undetermined respiratory illnesses are classified as
COPD
Which of the following creates a duty to act? Being dispatched to a call while on duty Seeing someone who is injured while you are off duty receiving a card from the national registry of EMT's All of the above
Being dispatched to a call while on duty.
If your unit is responsible for backcountry or steep terrain rescues, what special training should you have?
Belaying
Blood in the urine can indicate injury to which organ? Liver Spleen Bladder Kidneys
Bladder
Which hollow organ straddles both of the lower quadrants of the abdomen?
Bladder
What is a sign of placenta previa
Bleeding but no pain
Perfusion is assessed and monitored by measuring
Blood pressure
dependent lividity
Blood settling to the lowest point of the body, causing discoloration of the skin.
Hypoglycemia
Blood sugar less than 60
Conduction
Body heat is lost through direct physical touch of other objects
Radiation
Body heat is lost to the atmosphere or nearby objects without physically touching them
Convection
Body heat lost to surrounding air, which becomes warmer then rises and is then replaced by cool air and then repeat the cycle
Online medical control can best be accessed via which of the following? Radio Cell phone Both radio and cell Land lines only
Both radio and cell phones
bilateral
Both sides
The butt or feet of a baby presents first
Breech presentation
Albuterol: Action
Bronchodilator
Atrovent: Action
Bronchodilator
What is battle's sign? What could this be a sign of?
Bruising behind the ear Could be a sign of a skull fracture
Signs of internal bleeding include:
Bruising, swelling, and pain over vital organs; painful, swollen, or deformed extremities
a group of diseases characterized by the pathological limitation of airflow in the airway that is not fully reversible.
COPD
Your patient is a 14-year-old boy who crashed his bicycle while riding downhill at approximately 20 miles per hour. He has abrasions to his hands, posterior forearms, chest, and knees. These injuries should be treated as if they are which type of injury? Contusions Hematomas Fractures Burns
Burns. Although these injuries are abrasions, they are like burns in that a large area of skin has been damaged.
A 60-year-old man complains of chest pain. He is conscious and alert and denies shortness of breath. Which of the following questions would be the MOST appropriate to ask him? A. "Does the pain in your chest feel like a stabbing sensation?" B. "Does the pain in your chest move to either of your arms?" C. "Do you have any heart problems or take any medications?" D. "Were you exerting yourself when the chest pain began?"
C. "Do you have any heart problems or take any medications?"
You are interviewing a 52-year-old man who complains of chest discomfort. The patient is a retired paramedic and is very anxious because he thinks he is having a heart attack. Which of the following statements would be appropriate to say? A. "I notice that you are a retired paramedic, so I'm sure you will understand all of the things that we will be doing to you." B. "This is nothing to worry about. Please try to stay calm. The physician at the hospital will probably not find any signs of a heart problem." C. "It is possible that you are experiencing a heart attack. I am going to give you four baby aspirin to chew and swallow." D. "We need to take you to the ED stat. We will give you ASA and NTG en route and then reassess your vitals. Do you have any questions?"
C. "It is possible that you are experiencing a heart attack. I am going to give you four baby aspirin to chew and swallow."
A 4-year-old boy had an apparent seizure. He is conscious and calm and is sitting on his mother's lap. His father is sitting in a nearby chair. The child's mother suddenly begins crying uncontrollably, which causes the child to start crying. You should: A. reassure the child's mother that seizures in children are very common and that there is nothing to worry about. B. attempt to calm the child's mother, but avoid separating her from her child because this will increase her anxiety. C. consider asking the father to hold the child so you can assess him while your partner tries to calm the mother. D. give the child a favorite toy or blanket to hold onto and perform your assessment to the best of your ability.
C. consider asking the father to hold the child so you can assess him while your partner tries to calm the mother.
The patient care report (PCR) ensures: A. legal protection. B. quality assurance. C. continuity of care. D. research data.
C. continuity of care.
Calming and reassuring an anxious patient can be facilitated by: A. using medical terminology to ensure the patient understands. B. positioning yourself at a level that is higher than the patient. C. maintaining eye contact with the patient whenever possible. D. withholding unpleasant information until arrival at the hospital.
C. maintaining eye contact with the patient whenever possible.
When communicating with an older patient, it is important to remember that: A. speaking loudly and distinctly will ensure that the patient can hear you. B. your questions should focus exclusively on the patient's obvious problem. C. most older people think clearly and are capable of answering questions. D. hostility and confusion should be presumed to be due to the patient's age.
C. most older people think clearly and are capable of answering questions.
When providing a patient report via radio, you should protect the patient's privacy by: A. using coded medical language. B. withholding medical history data. C. not disclosing his or her name. D. refraining from objective statements.
C. not disclosing his or her name.
After receiving online orders from medical control to perform a patient care intervention, you should: A. ask the physician to repeat the order. B. confirm the order in your own words. C. repeat the order to medical control word for word. D. perform the intervention as ordered.
C. repeat the order to medical control word for word.
You could be sued for ___________ if your radio report to the hospital describes the patient in a manner that injures his or her reputation. A. assault B. negligence C. slander D. libel
C. slander
Typical components of an oral patient report include all of the following, EXCEPT: A. important medical history not previously given. B. the chief complaint or mechanism of injury. C. the set of baseline vital signs taken at the scene. D. the patient's response to treatment you provided.
C. the set of baseline vital signs taken at the scene.
You and your partner are dispatched to a residence for an "ill person." When you arrive, you find that the patient, a 44-year-old man, does not speak English. There are no relatives or bystanders present who can act as an interpreter. You should: A. speak to the patient with a moderately louder voice to facilitate his ability to understand what you are saying. B. refrain from performing any assessment or treatment until you can contact someone who can function as an interpreter. C. use short, simple questions and point to specific parts of your body to try to determine the source of the patient's complaint. D. give the patient oxygen, assess his vital signs, and transport him to the hospital in a position of comfort.
C. use short, simple questions and point to specific parts of your body to try to determine the source of the patient's complaint.
The condition of excessive fluid buildup in the lungs because of the inadequate pumping of the heart is called
CHF
You and your partner Jake arrive on scene of a soccer game where a man has possibly dislocated his knee. When you make patient contact there is obvious displacement of the lower leg and he has no distal pulses. What should you do?
Call medical control immediately for stabilization instructions
What is one of the complications with using cricoid pressure?
Can obstruct the airway if done improperly
What is the primary waste product from respiration?
Carbon dioxide
phrenic nerve
Carries impulses to the diaphragm from the brain.
What is the primary role of red blood cells?
Carry oxygen
Which of the following best describes the primary function of red blood cells? help fight infection help in forming blood clots carry oxygen carry glucose
Carry oxygen
A bullet traveling through the body causes tissue destruction through outward forces called?
Cavitation
mediastinum
Central compartment of the thoracic cavity. It contains the heart, the great vessels of the heart, esophagus, trachea, phrenic nerve, cardiac nerve, thoracic duct, thymus, and lymph nodes of the central chest.
The normal headfirst delivery of a baby is called a:
Cephalic presentation
Breathing may be impaired if the spine is injured at the level of which vertebrae? Cervical Thoracic Lumbar Sacral
Cervical
Your patient is complaining of pain in the right ankle after tripping on a step. The ankle is swollen, deformed, and tender. Which of the following best describes the assessment of circulation in relationship to splinting? Check the pedal pulse, splint the ankle, recheck the pedal pulse. Check the popliteal pulse, splint the ankle, recheck the pedal pulse. Check both the pedal and popliteal pulses, splint the ankle, recheck both the pedal and popliteal pulses. It is not necessary to check pulses when treating a joint injury.
Check the pedal pulse, splint the ankle, recheck the pedal pulse.
What are 5 signs of acute coronary syndrome (ACS)?
Chest pain, diaphoresis, tachycardia, dyspnea, nausea
perfusion
Circulation of blood within an organ or tissue in adequate amounts to meet current needs of the cells.
Adequate tissue perfusion depends on intact and functioning ___ and ___ systems
Circulatory;respiratory
quadrants of the abdomen
Describing where an abdominal organ or pain is located is made easier by dividing the abdomen into four imaginary quadrants. *Right upper quadrant (RUQ) *Left upper quadrant (LUQ) *Right lower quadrant (RLQ) *Left lower quadrant (LLQ)
Which organ can be found in all four quadrants? Colon Small intestine pancreas gallbladder
Colon
A patient has jumped from a second-story balcony and initially landed on his feet. What type of spinal fracture is most likely? Compression Distraction Flexion Extension
Compression
gross negligence
Conduct that constitutes a willful or reckless disregard for a duty or standard of care.
What type of heat loss occurs through wet clothing? Conduction Convection Radiation Evaporation
Conduction
CHF
Congestive Heart Failure failure of the heart to pump blood away from the heart causing accumulation of fluid in the tissues and lungs
Which of the following applies when seeking consent for treatment of a disturbed patient? Consent is not necessary for patients with a behavioral emergency. Consent is only necessary if you must restrain the patient. Consent is preferred, but implied consent may be used if the patient is a threat to himself, herself, or others. There is nothing you can do if the patient refuses treatment and transport.
Consent is preferred, but implied consent may be used if the patient is a threat to himself, herself, or others.
Activated Charcoal: Side Effects
Constipation, nausea, vomiting, bowel obstruction
What are the 3 effects of epinephrine? What is the dose?
Constricts vessels , increased HR, increased cardiac workload Dose: adult .3 , child .15
Your patient is a 45-year-old male who is complaining of chest pain. He is diaphoretic and pale. He refuses your treatment and transportation. Which of the following is most appropriate? Call law enforcement to place the patient under immediate detention so you can treat him. Tell the patient he is having a heart attack and there is a likelihood he will die within the next few hours. Have the patient sign a release and leave the scene. Contact medical direction and have the patient speak to the physician.
Contact medical direction and have the patient speak to the physician
During inspiration the intercostal muscles ___ and the diaphragm ___
Contract;contracts
Which of the following is associated with inspiration? Relaxation of the diaphragm Relaxation of intercostal muscles Contraction of intercostal muscles Passive movement of the chest wall
Contraction of the intercostal muscles
Losing heat from an uncovered head in cool weather with a light breeze is an example of what type of heat loss? Conduction Convection Radiation Evaporation
Convection
You are preparing to transport a patient whose arm has been amputated just above the wrist. You have retrieved the amputated part. Which of the following best described the proper care of it during transport? Wrap it in a dry, sterile dressing and place it next to the patient to keep it warm. Place it in a container of ice. Cover it with a sterile dressing, place in a plastic bag, and place the bag in a container of cooled water. Wrap it in a sterile dressing moistened with saline, then place it in a container of ice.
Cover it with a sterile dressing, place in a plastic bag, and place the bag in a container of cooled water.
cystic fibrosis
Cystic fibrosis results from a buildup of mucus in the lungs or gastrointestinal tract that interferes with breathing or digestion.
Which of the following statements is NOT appropriate to document in the narrative section of a PCR? A. "Significant damage was noted to the front end of the vehicle." B. "After oxygen was administered, the patient's breathing improved." C. "The patient admits to smoking marijuana earlier in the day." D. "General impression revealed that the patient was intoxicated."
D. "General impression revealed that the patient was intoxicated."
You and your partner are attempting to resuscitate a middle-aged female in cardiac arrest. Because of the remote location you are in, you are unable to contact medical control. What should you do? A. Make continuous attempts to contact medical control. B. Perform CPR only and initiate immediate transport. C. Ask the husband if he wants to continue resuscitation. D. Follow locally established protocols or standing orders.
D. Follow locally established protocols or standing orders.
You are transporting a 54-year-old male in cardiac arrest. An EMR is driving the ambulance as you and your partner attempt to resuscitate the patient. What is the MOST logical way of notifying the hospital? A. Call the receiving hospital with your cellular phone as you attempt resuscitation. B. Wait until you arrive at the hospital and then quickly apprise them of the situation. C. Request that a police officer respond to the hospital to apprise them of your arrival. D. Have the driver contact dispatch and relay the patient information to the hospital.
D. Have the driver contact dispatch and relay the patient information to the hospital.
Which of the following statements regarding a "dedicated line" is MOST Correct? A. It is a designated frequency on a portable radio that provides direct access to medical control. B. It is a constantly open line of communication that is under exclusive control of a single user. C. It is an exclusive frequency that is used by EMTs to communicate with each other in the field. D. It is a constantly open line of communication that cannot be accessed by outside users.
D. It is a constantly open line of communication that cannot be accessed by outside users.
During your assessment of a 20-year-old man with a severe headache and nausea, you ask him when his headache began, but he does not answer your question immediately. You should A. tell him that you cannot help him unless he answers your questions. B. ask him if he frequently experiences severe headaches and nausea. C. repeat your question because he probably did not hear you. D. allow him time to think about the question and respond to it.
D. allow him time to think about the question and respond to it.
You are assessing a 75-year-old woman with mild shortness of breath. As you are asking her questions regarding her chief complaint and medical history, you progressively move closer and closer to her. In doing this, it is important to remember that: A. it is necessary to enter an older person's intimate space because the elderly are typically hearing impaired. B. placing yourself in the patient's personal space is relaying to her that you can be trusted. C. a patient's personal space should not be violated, regardless of any barriers that may hamper communication. D. as you physically get closer to the patient, a greater and greater sense of trust must be established.
D. as you physically get closer to the patient, a greater and greater sense of trust must be established.
Any radio hardware containing a transmitter and receiver that is located in a fixed location is called a: A. multiplex. B. repeater. C. mobile radio. D. base station.
D. base station.
In what manner should you act and speak with a patient? A. loud and official B. passive C. authoritative D. calm and confident
D. calm and confident
Which of the following incidents does NOT require a report to be filed with local authorities? A. gunshot wounds B. animal bites C. spousal abuse D. cardiac arrest
D. cardiac arrest
After delivering your patient to the hospital, you sit down to complete the PCR. When documenting the patient's last blood pressure reading, you inadvertently write 120/60 instead of 130/70. To correct this mistake, you should: A. leave the error on your PCR but inform the staff of the patient's actual blood pressure. B. cover the error with Correction fluid and simply write the patient's actual blood pressure over it. C. attempt to erase the error, initial it, and then write the correct data on a separate addendum. D. draw a single horizontal line through the error, initial it, and write the correct data next to it.
D. draw a single horizontal line through the error, initial it, and write the correct data next to it.
Which of the following is NOT a function of the Federal Communications Commission (FCC)? A. licensing base stations and assigning appropriate radio call signs B. allocating specific radio frequencies for use by EMS providers C. monitoring all radio traffic and conducting field spot checks D. maintaining communications equipment on the ambulance
D. maintaining communications equipment on the ambulance
What type of communications equipment functions as a radio receiver and searches across several frequencies? A. mobile repeater B. duplex station C. simplex station D. scanner
D. scanner
When communicating information over the radio, you should: A. respond professionally by saying "please" and "thank you." B. limit any single transmission to 60 seconds or less and use 10 codes. C. use the patient's name only when communicating with the hospital. D. use the words "affirmative" and "negative" instead of "yes" or "no."
D. use the words "affirmative" and "negative" instead of "yes" or "no."
compensatory damages
Damages awarded in a civil suit that are intended to restore the plaintiff to the same condition that he or she was in prior to the incident complained about in the lawsuit.
punitive damages
Damages that are sometimes awarded in a civil suit when the conduct of the defendant was intentional or constituted a reckless disregard for the safety of the public.
putrefaction
Decomposition of body tissues.
During anaphylactic shock, the patient's BP is likely to ________.
Decrease
kussmaul respirations
Deep, rapid breathing to blow off excess acids.
You arrive on the scene of a motor vehicle collision. You are the first arriving unit and you can see immediately that you have at least four patients and that there are power lines involved. Which of the following should you do first? Begin triage to determine how serious the injuries are Call for the power company Determine the exact number of patients Begin treating the most seriously injured patient
Determine the exact number of patients before you call for additional help
You are on the scene of an unconscious adult without any indication of trauma. What is the most common cause of this situation? Diabetes Heart attack Seizures Stroke
Diabetes
What are two common causes of renal failure?
Diabetes and hypertension
Type 2
Diabetes mellitus initially begins with INSULIN RESISTANCE, where the cells are not able to use the insulin properly and pancreas loses its ability to produce adequate quantities of insulin.
What are the 3 signs and symptoms of poisoning
Difficult breathing, chest pain, coughing
Which of the following are the intended actions of epinephrine when administered for a severe allergic reaction? dilating the bronchioles and blood vessels constricting the bronchioles and blood vessels dilating the bronchioles and constricting the blood vessels constricting the bronchioles and dilating the blood vessels
Dilating the bronchioles and constricting the blood vessels
breach of confidentiality
Disclosure of information without proper authorization.
Your partner, a veteran EMT who you have worked with regularly for the past 4 years, seems unusually agitated during a call involving an elderly patient. Upon arrival back at your station, you note the obvious smell of alcohol on his breath. What should you do?
Discreetly report your suspicions to your supervisor.
What is dizziness and syncope?
Dizziness or light headedness A brief loss of consciousness
You come upon a victim of asphyxial cardiac arrest. Which of the following is the correct order of action?
Do CPR for 5 cycles or approximately 2 minutes and then activate the emergency response system and retrieve the AED
The anatomical planes of the human body are all of the following except:
Dorsal plane
Peritoneum
Double-layered membrane surrounding the abdominal organs
What are 2 examples of downers, uppers, narcotics, and hallucinogens?
Downers - alcohol, xanax Uppers - cocaine, ecstasy Narcotics - opium, morphine Hallucinogens - LSD, mushrooms
When an error is made on the report form, what should the EMT do?
Draw a line through the error, initial it, and write the correction.
Atrovent: Side Effects
Dry mouth, headache, gastrointestinal distress
How is pain described by acute coronary syndrom (ACS) patients?
Dull, crushing
The determination that prompt surgical care in the hospital is more important than performing time-consuming procedures in the field on a major trauma patient is based Mostly on...?
EMS research
Trauma is the leading cause of death in this age group:
Early adulthood
Which of the following dietary habitats is helpful in minimizing the effects of stress? Using caffeine to stay awake when working the night shift Having three to four alcoholic drinks a day Eating a variety of foods, limiting fat and sugar intake All of the above
Eating a variety of foods limiting fat and sugar intake
Which of the following requires mandatory reporting by health care personnel? Any patient with an infectious disease Elder, child, or dependent adult abuse Attempted suicide Use of illegal drugs
Elder, child, or dependent adult abuse.
The level of EMS provider that gives initial emergency care but does not usually transport patients is an:
Emergency Medical Responder
True or false: when providing a radio report to the receiving facility you should always include the patient's name so that they can pull any medical records
False
Your patient is a 42-year-old male who received a knife wound to the abdomen in a bar fight. As you approach you see that he has a loop of intestine protruding from the wound. Which of the following is the highest priority in the treatment of this patient? Cover the exposed intestine with a sterile, moist dressing. Ensure adequate breathing Control bleeding from the wound Arrange spinal immobilization
Ensure adequate breathing
What should you do before attempting to access a patient trapped in a vehicle?
Ensure the vehicle is stable.
The fundamental pathophysiology of the immune systems response to allergens include all of the following except:
Envenomation
Epinephrine: Dosage
Epi-Pen = 0.3mg, Epi-Pen Jr = 0.15mg (for <60 lbs)
What term is used to describe the outermost layer of the skin?
Epidermis
The leaf-like structure that covers the trachea is the
Epiglottis
The leaf-shaped structure that covers the trachea to protect the airway from liquids and food is the:
Epiglottis
Rhyme for glasgow
Evm 456 Eye 4 Verbal 5 Motor 6
When log rolling a patient onto a backboard you should always?
Examine the posterior quickly
direct contact
Exposure or transmission of a communicable disease from one person to another by physical contact.
indirect contact
Exposure or transmission of disease from one person to another by contact with a contaminated object.
A face striking the windshield of a car is likely to cause what type of spinal injury? Compression Distraction Flexion Extension
Extension
You have been dispatched to an 81 year old female complaining of difficulty breathing and chest pain. You are auscultating her lungs and discover rales. Which of the following conditions would you suspect?
Failure of the left ventricle
negligence
Failure to provide the same care that a person with similar training would provide.
Which of the following mechanisms is most consistent with the potential for spinal injury? Motor vehicle collision into a stationary object at 15mph with a restrained occupant. Gunshot wound just below (distal to) the knee. Fall from the top step of a 4ft stepladder, landing head-first on a concrete patio. Being tackled in a game of football
Fall from the top step of a 4ft stepladder, landing head-first on a concrete patio.
True or false: All patients with an epinephrine auto-injector who are experiencing an allergic reaction should be assisted in administering their auto-injector
False
True or false: Cardiac problems are also a frequent cause of shock in infants and children.
False
True or false: Giving a report over the radio makes the verbal report on arrival at the hospital unnecessary
False
True or false: Once a severe allergic reaction is treated with epinephrine the patient does not require further treatment
False
True or false: Sudden infant death syndrome affects children up to age 3
False
True or false: your patient is an 8-year-old female who was accidentally stabbed in the thigh by her brother. You estimate she has lost 2 cups of blood. This amount of bleeding is of no concern in a child this age.
False
slander
False and damaging information about a person that is communicated by the spoken word.
libel
False and damaging information about a person that is communicated in writing.
True or false: your patient has fallen about 15 feet from a ladder to the ground. He is awake and alert, complaining of pain in his left thigh. His pulse is 88, respirations are 18, and blood pressure is 128/88. Therefore, you can rule out the possibility of internal bleeding and shock.
False.
True or false: it is not advisable for the EMT providing patient care to wear a seat belt.
False. It is always advisable while moving, but may not be worn when administering life saving care.
True or false: any patient who has been drinking alcohol is incompetence to consent or refuse medical care
False. The mere ingestion of alcohol dors not mean that a patient is not competent to consent to medical care.
distal
Far from point of reference
For which of the following fracture locations is a traction splint indicated? Pelvis Femur Knee Tibia
Femur
What are two critical fractures
Femur and pelvis
Which of the following is not a nationally recognized level of EMS provider? EMR EMT First Responder Paramedic
First responder
What are 5 signs and symptoms of renal colic?
Flank pain, pain when urinating, fever, nausea, and vomiting
When lifting a patient how should your feet be positioned?
Flat and evenly spaced
Which of the following is the MOST effective strategy for managing stress?
Focus on delivering high-quality patient care..
Secondary assessment for trauma minor injury
Focused on injury Vitals Sample Then detailed exam in the back of truck
Which of the following is not an example of medical direction? Standing orders Protocols Following paramedics' verbal orders Following physicians' radio orders
Following paramedics' verbal orders is not an example of medical direction.
What is the standard dose for aspirin for cardiac patient? What are the contraindications?
Four 81 mg tablets Bleeding and asthma
What are two types of seizures and their affects?
Generalized: affect entire brain and DOES affect consciousness Partial: Affects only one part or one side of the brain and it MAY cause a loss of consciousness
Give blow by oxygen and carefully monitor during transport.
Give blow by oxygen and carefully monitor during transport.
You are standing by at a local sporting event when a mother rushes up to you with a 3 year old boy in her arms. " He was playing with my car keys and then just started gagging and coughing!", she tells you in a panic. The child is having difficulty breathing and crying along with audible inspiratory stridor. What should you do?
Give blow by oxygen and carefully monitor during transport.
Epinephrine: Contraindications
Glaucoma, shock other than anaphylactic, diabetes, cardiac problems, hypertension, pregnancy, meds include a beta blocker or MAOI
Cellular metabolism requires a constant supply of oxygen and ____
Glucose
Which of the following medications may be carried on a BLS ambulance for administration by an EMT? Aspirin Epinephrine Albuterol Glucose
Glucose
What is the body's basic source of energy?
Glucose is the basic source of energy that sugars are converted to for energy in the body.
Your partners spouse is placing a lot of pressure on her because of the time she spends away from him doing her job. She says she does not know what to do about it, but it is really "stressing her out." What response would be most appropriate?
Have you thought about requesting a shift that might allow you to spend more time together?
Which of the following is the EMT's primary role when managing a scene in which a patient is entrapped in a vehicle? Patient care Hazard control Control of bystanders Use of extrication tools
Hazard control
Your patient is a 46 year male with Type 1 diabetes. His girlfriend called 911 after she came home late from work and found him curled up on the floor of the bathroom with a towel under his head. There is no visible sign of trauma. He will not respond to you and his respirations are adequate depth and rate at 16 per minute. The girlfriend tells you that she just spoke to him on the phone a few hours ago and he seemed fine. What is the most likely cause of the this man's altered LOC
He took his insulin, but has not eaten. He is hypoglycemic.
What are the 6 signs of carbon monoxide poisoning? What is the treatment?
Headache, AMS, breathing difficulty, dizziness, cyanosis, nausea Treatment: O2, get out of area
Epinephrine: Side Effects
Headache, palpitations, hypertension, tachycardia
Albuterol: Side effects
Headache, tachycardia, hypertension
Example of cardiogenic shock
Heart attack Congenital heart failure Abnormal rhythm Beta blockers
Which of the following describes the progression of heat-related illness, from mildest to most severe? Heat cramps, heat exhaustion, heat stroke. Heat exhaustion, heat stroke, heat cramps. Heat stroke, heat cramps, heat exhaustion. Heat cramps, heat stroke, heat exhaustion.
Heat cramps, heat exhaustion, heat stroke.
Your patient was riding his bicycle in hot, humid weather. He is now complaining of weakness and nausea. His skin is pale, cool, and clammy and he has a rapid heart rate. This is most consistent with which conditions? Heat cramps Heat exhaustion Heat stroke Heat rash
Heat exhaustion
Proper body mechanics are best described by bending at the ___ and lifting with the ___
Knees;legs
The integumentary system:
Helps regulate body temperature as well as providing the body protection from the environment
Examples of hypovelemic shock
Hemorrhagic loos whole blood Non hemmorrhgagic Fluid loss and burns
HEPA Mask
High Efficiency Particulate Air respirator; used for patients with suspected TB; worn by the EMT provider to prevent airborne transmission
What is urticeria and angioedema?
Hives and swelling of the face
History and assessment findings for hyperglycemia/diabetic ketoacidosis may include all of the following except:
Hunger
Your patient is a 50-year-old male who takes Orinase. His family reports a two-day history of progressive lethargy. The patient's skin is warm, flushed, and dry. Which of the following is most likely? Hypoglycemia Hyperglycemia A problem not related to diabetes Allergic reaction to Orinase
Hyperglycemia
What is hyperglycemia? What are 2 causes and 5 signs?
Hyperglycemia is high blood sugar Causes: decreased insulin, stress Signs: develops over days or weeks, chronic thirst, hunger, polyuria, nausea
Your patient is a known diabetic who took his insulin but has not eaten as scheduled. He is confused and uncooperative. What should you suspect? Diabetic coma Seizure Hyperglycemia Hypoglycemia
Hypoglycemia
What is hypoglycemia? What are 2 causes and 7 signs?
Hypoglycemia is low blood sugar Causes: too much insulin, malnutrition overexerts Signs: rapid onset, abnormal behavior, pale, sweaty, tachycardia, tachypnea, seizures
____ shock occurs when the body has massive fluid loss
Hypovolemic
Types of shock
Hypovolemic Distributive Cardiogenic Obstructive
What should I do with someone had a spontaneous abortio.
Transport because there is lots of blood that may be lost
governmental immunity
If your service is covered by immunity, it may mean that you cannot be sued or it may limit the amount of the monetary judgment that the plaintiff may recover; generally applies only to EMS services that are operated by municipalities or other governmental entities.
emergency medical care
Immediate care or treatment.
Your patient is found outdoors in cold weather with rain-soaked clothing. The specific terminology for this is which type of hypothermia? waterborne wet submersion immersion
Immersion
ASA: Action
Impedes blood clotting
Smooth muscle is found in which of the following? In the heart In the nervous system Attached to bones In organs and blood vessels
In organs and blood vessels
Shock
Inadequate tissue perfusion Also know as hypoperfusion
Brain herniation
Increasing intracranial pressure related to the presence of lg pocket of blood (hematoma)
Respiratory Distress
Indicates that a patient is breathing but is having trouble doing so. May lead to respiratory arrest.
A hip injury caused when a knee strikes the dashboard is an example of what kind of force? Direct force Indirect force Twisting force Traction force
Indirect force
In which of the following age groups is capillary refill time most useful as an indicator of impaired perfusion, or shock? Young adults and the elderly Children and young adults Infants and children All of the above
Infants and children
What is appendicitis and 4 signs and symptoms?
Infection of appendix RLQ pain, nausea, pain referred to umbilical region, fever
Tuberculosis
Infectious disease caused by the tubercle bacillus, Mycobacterium tuberculosis. Most commonly affects the respiratory system and causes inflammation and calcification of the system.
hepatitis
Inflammation of the liver, usually caused by a viral infection, that causes fever, loss of appetite, jaundice, fatigue, and altered liver function.
What are the 3 effects of histamines?
Inflammation, bronchoconstriction, vasodilation
Which type of poison is likely to cause a scene to be hazardous?
Inhaled
A 6 year old girl was found outside in her yard unconscious. She is breathing 6 breaths a minute and her pulse is 58 bpm with poor systematic perfusion. What should you do?
Initiate chest compressions and assist ventilations with high flow O2
Which of the following lowers blood sugar levels?
Insulin
The parasympathetic nervous system would be responsible for?
Intestinal activity and slowing down the heart
Which of the following is not a route by which the EMT administers drugs? Intravenously Orally Sublingually Inhalation
Intravenously.
Cavacation
Is the cavity that is formed by a pressure way
What are two kinds of stroke and their causes?
Ischemic: blockage Hemorrhagic: bleeding out
In neck injuries that a jugular vein or carotid artery is involved, proper management involves which of the following? Apply direct pressure Isolate and compress the ends of the vessel Apply pressure to the points Apply a pressure dressing
Isolate and compress the ends of the vessel
Why would inserting a suction catheter into the mouth with the suction active be incorrect?
It depletes the patient's oxygen supply
What is the fundal massage and its function?
It is a massage after birth that allows the placenta to come out and helps to stop bleeding
What is a stroke? What can cause them?
It is death or injury of brain tissue from O2 deprivation Causes: blockage of artery from supplying blood to part of the brain
Which of the following statements regarding the Good Samaritan law is correct?
It will not protect the EMT in cases of gross negligence
All of the following indicate a severe allergic reaction requiring immediate prehospital treatment by the EMT except which of the following? Labored breathing Itching Stridor Hypotension
Itching
You arrive on the scene of a patient who has fallen 15 feet from a ladder onto solid ground. The patient is not responding to painful stimuli. The correct way to open this patient's airway is to use a ___ maneuver
Jaw-thrust
OPA's and NPA's can become ineffective at maintaining the airway if you don't?
Keep the head in the proper position
What is the best way to accomplish a power lift?
Keep the surface of your hands in contact with the stretcher
Dialysis is a treatment for patients who have failure of which organ?
Kidneys
Flank pain typically will involve which organ?
Kidneys
Flank pain would lead you to be concerned about injury to which organ? Liver Spleen Bladder Kidneys
Kidneys
Which of the following organs in the retroperitoneal space? Liver Spleen Bladder Kidneys
Kidneys
We start to see degradation of body functions in which age group?
Late adulthood
When administering the auto-injector, it should be positioned midway between the hip and knee on which aspect of the thigh? Lateral Medial Anterior Posterior
Lateral
Which of the following is not considered personal protective equipment for rescue situations? Turnout gear Helmet Eye protection Latex or vinyl gloves
Latex or vinyl gloves
order of circulation
Left Atrium-Left Ventricle-Aorta-Arteries-Arterioles-Capillaries-Venules-Veins-Superior and Inferior Vena Cava-Right Atrium-Right Ventricle-Pulmonary Artery-Lungs-Pulmonary Vein
What are the 3 coronary arteries?
Left anterior descending, left circumflex, right coronary artery
Blood returning to the heart from the lungs enters which chamber?
Left atrium
Your patient is a 5 year old boy who has fallen off a bunk bed and struck his face on the lower railing. His mentation seems impaired and you are concerned he has a head injury. He is very afraid of you and he begins crying every time you attempt to administer O2. Which of the following answers contains the most appropriate action?
Let the parent hold the oxygen tubing next to the child's face during transport.
Which of the following principles should be used when managing a disturbed patient? Let the patient know you want to help Ensure that law enforcement has restrained the patient before speaking to him or her Only say what is necessary to conduct your physical exam Tell the patient you know how he or she feels
Let the patient know you want to help
Your patient is a 19-year-old male who was beaten with a metal pipe. He is unresponsive, but you are managing his airway. He has bleeding from his right ear canal. Which of the following is an acceptable method of managing bleeding from the patient's ear? Lightly cover the ear with an absorbent dressing. Pack gauze into the ear. Allow the ear to drain freely without covering it. Cover the ear with an occlusive dressing, such as petroleum gauze.
Lightly cover the ear with an absorbent dressing.
Tenderness in the upper right quadrant of the abdomen would lead you to be concerned about injury to which organ? Liver Spleen Bladder Kidneys
Liver
The large solid organ that takes up much of the right upper quadrant of the abdomen and crosses into the left upper quadrant is which of the following? Spleen Liver Pancreas Colon
Liver
Solid organs in abdominal
Liver Spleen Kidneys Pancreas
What is a very late sign of an ectopic pregnancy?
Low BP
What is wheezing?
Lower airway sound on expiration
How would a patient described as prone be positioned?
Lying face-down
Penetrating truma
Made a cut through
The EMT's first responsibility is:
Maintaining personal safety
When communicating with your patient, which of the following is most appropriate? Make and keep eye contact Tell the patient what you think the diagnosis is Always reassure the patient that everything will be alright
Make and keep eye contact
You have decided a patient is confident to refuse care. You should do all of the following except: Tell the patient he or she may call back if he or she changes his or her mind Have the patient sign your report to acknowledge refusal of care Have someone other than your partner sign the report as a witness Make sure the patient understands that he or she may die and it will not be your fault
Make sure the patient understands that he or she may die and it will not be your fault
People who have unequal pupils ?
May be normal
Medium and high velocity injuries
Med/High velocity projectiles are from pellets or bullets. The damage caused, depends on the Trajectory and the dissipation of energy. Dissipation of energy is affected by Drag,Profile,Cavitation, & Fragmentation.
Which part of the brain is most responsible for regulation of normal breathing?
Medulla oblongata, which is part of the brain stem.
Involuntary
Mentally incompetent person
The minimum EMS data set is established at which of the following levels? National Municipal State Provider service
National
proximal
Near the point of reference
You and your partner Stewart arrive on scene to find a woman who has suffered a blunt trauma to her spine that has resulted in her apparent paralysis as well as a state of shock. What type of shock is she likely suffering from?
Neurogenic shock can be seen in spinal cord injuries
Room air is made primarily of what gas?
Nitrogen
An increase in the incidence of type II diabetes can be seen in what age group?
Middle adulthood
. Assessment findings and symptoms for a patient that has taken a hallucinogen include all of the following except:
Miosis
With injuries to the head and face, it is important to take which of the following actions? Check distal pulses Monitor LOC Monitor the airway
Monitor LOC and Monitor the airway
Parietal pain
More severe pain and more localized
scope of practice
Most commonly defined by state law; outlines the care you are able to provide for the patient.
Order of preference for artifical breathing techniques, best to worst
Mouth to mask, 2-rescuer BVM, Flow-restricted O2 powered device, 1-rescuer BVM
Which of the following is indicated in the treatment of a patient having a seizure? Restrain the arms and legs Move things out of the patient's way Insert an oral airway Place a tongue blade between the teeth
Move things out of the patient's way
Urgent Move
Move used if a scne factor causes a decline in patient's condition, or if the treatment of a patient requires a move.
Factors that may increase bleeding
Movement Low body temp clotting less effective Medication anticlotting like aspirin Intravenous fluids Removal of bandages
Treatment of a Minor
Must be given by legal guardian
Who decides what the minimum data set is for a PCR?
National Education Standards lists the minimum data set for PCRs
As air is moved through the respiratory system, oxygen is moved from the capillaries into the bloodstream and is picked up and transported by what component of the blood?
Red cells
in loco parentis
Refers to the legal responsibility of a person or organization to take on some of the functions and responsibilities of a parent.
What are 5 complications of sickle cell anemia?
Stroke, destruction of the spleen, acute chest, sickle pain crisis, priaprism
A hematoma beneath the outermost layer of the tissues covering the brain is classified as which of the following? Epidural Subdural Intracerebral Subarachnoid
Subdural
Which of the following best describes the depth of a burn that only involves the epidermis? Full thickness Partial thickness Superficial Moderate
Superficial
What is the best position for an unresponsive patient who does not require airway management or ventilation and who does not have a suspected spinal injury?
On his or her side to protect the airway
unilateral
One side
What are 3 signs of stroke?
One sided weakness (hemiparesis) , difficulty speaking (aphasia), and headache
What is the dose for nitroglycerin? What is the contraindication?
One tablet (4 mg) Low blood pressure
depositions
Oral questions asked of parties and witnesses under oath.
Medical Direction
Oversight of the patient-care aspects of an EMS system by the Medical Director.
Your 65-year-old male patient is complaining of chest pain. His heart rate is 60 and blood pressure is 94/68. He states he has taken two of his nitroglycerin tablets. Which of the following medications should you administer? Another nitroglycerin tablet Oxygen both nitroglycerin and oxygen none of the above
Oxygen. It is contraindicated to give a patient nitroglycerin tablets when he or she has already taken several of them.
You just delivered an infant in the field. You notice the mother has brisk vaginal bleeding. All of the following are recommended ways of managing this problem EXCEPT which of the following? Packing the vagina with gauze Massaging the uterus Placing a sanitary napkin over the perineal (vaginal) area Encouraging the mother to nurse the infant
Packing the vagina with gauze
Visceral pain
Pain is less severe and poorly localized because of lack of pain receptors on the organ pain is generalized
palmar
Palm of hand
Insulin is secreted from which organ?
Pancreas
You are dispatched to a possible cardiac arrest. You arrive 10 minutes from the time of the call. You and your partner enter the residence to find a man in his 50's lying supine on the living room floor. His wife says that he "just collapsed" while eating dinner. Which of the following treatment choices is most appropriate at this time according to AHA Guidelines?
Perform 30 compressions and then look inside the mouth before attempting to ventilate
The skin between the vagina and the anus that may tear during delivery is referred to as which of the following? Urethra Perineum Vulva Cervix
Perineum
informed consent
Permission for treatment given by a competent patient after the potential risks, benefits, and alternatives to treatment have been explained.
Expressed Consent
Permission that must be obtained from every conscious, mentally competent adult before emergency treatment may be provided
consent
Permission to render care.
Polst
Physicians orders for life sustaining treatment. May include order for DO NOT RESUSCITATE
To control bleeding from the nose not caused by injury, you should do which of the following? Pinch the nostrils firmly together Pack the nose with gauze Put ice on the patient's face Not attempt to control the bleeding.
Pinch the nostrils firmly together
Best describe the proper way to clamp and cut the umbilical cord:
Place a clamp about four finger widths from the baby; place a second clamp about 2 inches closer to the mother and cut the cord between the clamps.
Your patient has a jagged piece of glass embedded in a wound on the palm of his left hand. Which of the following best describes the proper management of this wound? Apply a pressure dressing over the object to stabilize it and controll bleeding. Place bulking dressing material around the object and bandage it in place to stabilize the object Remove the object before applying a pressure dressing to the wound Use an occlusive dressing, such as petroleum gauze, to seal the edges of the wound around the object.
Place bulking dressing material around the object and bandage it in place to stabilize the object.
Which of the following should be considered when managing the airway and ventilation of a small child? Suction as long as necessary to clear the airway Hyperextended the head as far as possible Place padding under the shoulders to position the head Use a nasal cannula at a high flow rate to provide ventilations
Place padding under the shoulders to position the head
To assess the general body temperature of the patient the EMT should do which of the following? Place the back of the hand on the patient's forehead Place the back of the hand between the patient's clothing and abdomen Place the back of the hand in the patient's palm Place the back of the hand in the small of the patient's back
Place the back of the hand between the patient's clothing and abdomen
Common diseases from crackles
Pneumonia Pulmonary edema
No breath sounds on one side of the chest indicate which injury? Pneumothorax Rib fracture Pericarial tamponade sucking chest wound
Pneumothorax
Activated Charcoal: Contraindications
Poor LOC, vomiting
A handheld radio communication device is referred to as:
Portable radio
The two primary causes of airway blockage (compromise) are:
Position and foreign object
PCR
Prehospital care report
You have been called to respond to a sick person in a residence. Your patient is a 65-year-old female who does not respond to verbal or painful stimuli. After the initial assessment, which of the following should be performed next? SAMPLE history detailed physical exam primary assessment focused history and physical exam
Primary assessment
infection control
Procedures to reduce transmissions of infection among patients and health care personnel
Under which emergency situation is it permissible to insert a gloved hand into a patient's vagina?
Prolapsed cord
cumulative stress reactions
Prolonged or excessive stress
personal protective equipment (PPE)
Protective equipment that OSHA requires to be made available to the EMT. In the case of infection risk, PPE blocks entry of an organism into the body.
standard precautions
Protective measures that have traditionally been developed by the Centers for Disease Control and Prevention (CDC) for use in dealing with objects, blood, body fluids, or other potential exposure risks of communicable disease.
If patient been in cardiac arrest for more than 5 min and no CPR has been done what do you do
Provide 2 min of CPR before ard
When writing a narrative, is it important that the EMT do all of the following except which of the following? Describe the patient's condition Include pertinent negatives Include treatments provided Provide a diagnosis of the patient's condition
Provide a diagnosis of the patient's condition.
Example of obstructive shock
Pulmonary edema Blood can't move forward Pericardial tamponade Tension pneumothorax Both put pressure on Herat and can't fill appropriately
Management of hypoglycemia may include aspects of all the following except:
Pulse oximetry
This increases in adults with breathing difficulty.
Pulse rate
What is PMS
Pulses motor function Sensation
You and your partner Max are called to a house where a 72 year old man is having chest pain and complaining of trouble breathing. The man is diaphoretic and has a pulse of 107, respirations of 24, and a BP of 160/84. He says he has never had any heart problems or breathing difficulty before this. What should you do next?
Put him on O2 at 15 lpm and transport
open-ended questions
Questions for which the patient must provide detail to give an answer.
close-ended questions
Questions that can be answered in short or single word responses.
Your patient was the unrestrained driver of a vehicle that struck a large tree at 45mph. He is unresponsive to painful stimuli, has rapid, weak pulses, and shallow ventilations. Which of the following actions is in the patient's best interest? Quickly apply a cervical collar and short spinal immobilization device, remove the patient onto a long backboard, secure him to the board,load him in the ambulance, and then begin assessment and treatment en route to the hospital Quickly apply oxygen, while maintaining manual stabilization of the cervical spine, apply a cervical collar, and rapidly but carefully remove the patient onto a long backboard Apply oxygen, complete a detailed physical examination including vital signs, and then rapidly extricate the patient onto a long backboard. Immediately pull the patient from the vehicle onto the ground while stabilizing the head and neck as much as possible with your forearms.
Quickly apply oxygen, while maintaining manual stabilization of the cervical spine, apply a cervical collar, and rapidly but carefully remove the patient onto a long backboard
What are 5 signs and symptoms of cholecystitis?
Radiates to the shoulder, tenderness in the abdomen, fever, nausea, and vomiting
VHF (very high frequency)
Radio frequencies between 30 and 300 MHz; the VHF spectrum is further divided into "high" and "low" bands.
The correct dosage for nitroglycerine is one tablet repeated how many times?
Repeat two more times and if pain is not yet relieved, request ALS and transport patient.
What describes a device that receives a signal from a low-power portable or mobile and transmits it at a higher power on another frequency?
Repeater
Which of the following is the correct response to a disturbed patient's hallucinatory thoughts? "You are experiencing hallucinations because you are mentally ill." Go along with the hallucination to comfort the patient. Rephrase what the patient has said in your own words to show you are listening. Point out that it is not possible to see or hear what the patient says he or she is seeing or hearing.
Rephrase what the patient has said in your own owrds to show you are listening.
respiration vs ventilation
Respiration is the process of gas exchange, whereas ventilation is the simple movement of air between the lungs and the environment
Which of the following situations would most predictably produce critical incident stress in EMS personnel? Repeatedly responding to the same address for a patient who does not really seem to be sick Delivering a baby Responding to an elderly female who was forced by her caregiver to sit in a bathtub of hot water until she received full thickness (third-degree) burns Inability to successfully resuscitated an 80-year-old male who was found in cardiac arrest in his bed
Responding to an elderly female who was forced by her caregiver to sit in a bathtub of hot water until she received full thickness burns. Some of the situations that commonly produce stress reactions and EMS personnel include: mass casualty incident situations, trauma to infants and children, amputations, infant child elder or spousal abuse, and death or injury of a coworker or other public safety personnel.
What are the 5 rights of administering medications?
Right person, right time, right route, right medication, right dose
Which section of the EMS form includes date and times?
Run data
ipsilateral
Same side
Secondary assessment for medical responsive
Sample Focused on injury Vitals
What is the first part of the patient assessment process?
Scene size up
You are caring for an injured child who expresses concern over disfigurement from her injury. This child is most likely in which of the following age groups? Infant Toddler Preschool School-age
School-age
In the elderly population, many AMIs do not present with the symptoms that are normally associated with AMIs. This is referred to as?
Silent heart attack
Ruptured uterus sign
Searing or tearing feeling in abdomen
Injuries to hollow organs that go undiagnosed for an extended period of time may lead to wound infection or ____________________. The contents of the organ spilling into the peritoneal space may cause__________________.
Sepsis / peritonitis
Examples if distributive shock
Septic Infection that causes the vessels to dilate Neurogenic Spinal cord injury cause vessels to dilate Anaphylactic Body wide vessel dilation
What is anaphylaxis and its 3 main causes?
Severe life threatening allergic reaction Causes: hypotension, respiratory failure, and airway obstruction
Where do I put epipen when done
Sharp object container
Your unit is called to a youth summer camp for an unknown illness of a 14 year old girl. The counselor who called 911 stated that the girl started vomiting while playing basketball and is now complaining of stomach pain. You arrive to find the girl sitting in the camp office clutching her stomach. She is very overweight and slightly diaphoretic with pink skin that feels like a normal temperature. When you take her pulse she starts complaining of "feeling weak". She is AOX3. What is most likely wrong with this girl and which answer contains the most appropriate treatment?
She is suffering from heat cramps and should be given small sips of cool water if her LOC is not impaired. Move her to a cool area and actively cool her by misting her with tepid water and then fanning her to allow for evaporation. Apply high flow O2, administer IV fluids if scope of practice allows, and transport.
5 Stages of hypothermia
Shivering Apathy and decreased muscle function Decreased level of responsiveness Decreased vital signs Death
What are the 3 signs and symptoms of pneumonia?
Shortness of breath, chest pain, fever
A loss of 15% of blood volume is
Significant and can lead to shock
Narrow pulse pressure indicates
Significant loss of blood
simplex
Single-frequency radio; transmissions can occur in either direction but not simultaneously in both; when one party transmits, the other can only receive, and the party that is transmitting is unable to receive.
You should encourage a nosebleed patient to do which of the following? Apply ice to the back of the neck Hold his head down between his legs Sit up and lean forward Sit up and lean his head back
Sit up and lean forward
Your patient has a history of asthma and is complaining of difficulty breathing. There is no potential for spinal injury. This patient should be placed in which position?
Sitting
What are 3 signs of hyperglycemia?
Slow onset, polyuria, polyphagia (increased hunger)
mobile data terminals (MDT)
Small computer terminals inside ambulances that directly receive data from the dispatch center.
plantar
Sole of foot
Oral
Swallowed
edema
Swelling of body tissues due to an excessive accumulation of fluid in connective tissue or a serous cavity
When caring for special needs patients, you should:
Speak slowly and clearly, positioned directly in front of the patient.
Which of the following is part of the central nervous system? Skull Spinal cord Vertebrae All of the above
Spinal cord
Pain in the upper left quadrant indicates possible injury to which organ? Liver Spleen Bladder Kidneys
Spleen
Soild organs
Spleen liver pacreas kidneys
In open fractures with bone protruding from the wound, what should the EMT do? Push the bone back in. Pull on the extremity until the bone drops back into place. Splint the injury in a way that protects the bone end. Cover the bone end but do not splint.
Splint the injury in a way that portects the bone end.
The laws that govern the practice of EMS are typically enacted at the ___ level
State
You responds to a home where an 85-year-old male apparently died in his sleep during the night. The body is cool to the touch, mottled, and rigored. The patient's wife is looking at you anxiously, asking, "isn't there anything you can do?" What is the best way to handle this situation?
State, "I am sorry ma'am. Your husband is dead. "
Good Samaritan laws
Statutory provisions enacted by many states to protect citizens from liability for errors and omissions in giving good faith emergency medical care, unless there is wanton, gross, or willful negligence.
Which of the following best describes the EMT's role at the scene of a hazardous materials incident? Actively deconatminates patients in the warm zone Enters the hot zone to remove the patients for decontamination and treatment Stays in the cold zone to receive patients after they are decontaminated Provides patient care in the warm zone
Stays in the cold zone to receive patients after they are decontaminated
rigor mortis
Stiffening of the body; a definitive sign of death.
Hollow organ in abdominal
Stomach Gallbladder Urinary bladder Ureters Internal urethra Fallopian tubes Intestines
Which of the following best explains how defibrillation works? restarts the heart when it has stopped, resorting electrical activity to the heart causes the heart muscle to contract more effectively, restoring a pulse increases the heart rate, resulting in better circulation stops chaotic electrical activity, allowing the heart's own pacemaker to take over again.
Stops chaotic electrical activity, allowing the heart's own pacemaker to take over again
Glycogen
Storage form of glucose
bariatric stretcher
Stretcher for obese patients
thorax
The chest cavity that contains the heart, lungs, esophagus, and great vessels.
defamation
The communication of false information about a person that is damaging to that person's reputation or standing in the community.
false imprisonment
The confinement of a person without legal authority or the person's consent.
signs of severe hypoxia
Tachypnea Dyspnea Cyanosis Tachycardia may lead to dysrhythmias and eventually bradycardia Confusion Loss of coordination sleepy appearance Head bobbing Slow reaction time Altered mental status
signs of mild hypoxia
Tachypnea Dyspnea Pale cool clammy skin ( early) Elevation of blood pressure Agitation Disorientation and confusion ( from high carbon dioxide levels) Headache
trunking
Telecommunication systems that allow a computer to maximize utilization of a group of frequencies.
Defibrillation is used to _____________.
Terminate life threatening rhythm disturbances
You arrive on scene with your partner Ruben to a multiple car accident where you are the 3rd ambulance to arrive on the scene. You are told that there are 6 patients in 4 cars all requiring extrication. In the first car is a 21 year old woman who is 37 weeks pregnant, conscious, and crying - a 16 year old boy who is crying and complaining of back pain - and a 6 year old girl who has abrasions on her face and an open fracture of the ulna. She is conscious but her breathing is shallow and appears labored. In the second car is a 67 year old woman who is pinned against the steering wheel with visible brain matter. She has no pulse. In the third car are 2 teenagers who are complaining of neck pain and appear to have an altered LOC. Neither was wearing a seatbelt and both have lacerations about their faces and on their heads. Who should be receiving treatment first?
The 6 year old girl
Which of the following best describes how a fully automatic defibrillator is used? The EMT applies it to the patient and turns it on The EMT manually triggers defibrillation by depressing a button on the machine in response to a command from the machine The machine responds to the EMT's voice commands The EMT must interpret the patient's cardiac rhythm and determine whether defibrillation is neccessary
The EMT applies it to the patient and turns it on
What does the NREMT provide?
The NREMT provides a national standard for EMS testing
duplex
The ability to transmit and receive simultaneously.
infection
The abnormal invasion if a host or host tissues by organisms such as bacteria, viruses, or parasites, with or without signs or symptoms of disease.
hemopneumothorax
The accumulation of blood and air in the pleural space of the chest.
forcible restraint
The act of physically preventing an individual from initiating any physical action.
At the ER a physician approaches you with an MRI of your patient's spine. The spinal cord appears to be about 25 mm in diameter. You know this is strange because the diameter of an average normal spinal cord is approximately?
The average normal spinal cord is approximately 10 mm in diameter.
Which of the following best explains the cause of a heart attack? The electrical system of the heart dysfunctions The blood supply to the heart muscle is disrupted One or more chambers of the heart rupture A blood clot forms in one of the chambers of the heart
The blood supply to the heart muscle is disrupted
immune
The body's ability to protect itself from acquiring a disease.
general adaptation syndrome
The body's response to stress that begins with an alarm response, followed by a stage of reaction and resistance, and then recovery or, if the stress is prolonged, exhaustion.
Implied Consent
The consent it is presumed a patient or patient's parent or gaurdian would give if they could, such as for an unconscious patient or a parent who cannot be contacted when care is needed.
You arrive on scene with your partner Abe to find a 64 year old woman who is very obese. Her son tells you she has a heart condition. She is unconscious with a baggie of what appears to be street drugs next to her. She is breathing at 18 breaths a minute and they are regular. Her pulse is 99 and her BP is 90/50. What is likely the cause for the low blood pressure?
The drugs
Heat stroke
The failure of the heat-regulating ability of an individual under heat stress. Skin will be hot and red possibly not sweating
Federal Communications Commission (FCC)
The federal agency that has jurisdiction over interstate and international telephone and telegraph services and satellite communications, all of which may involve EMS activity.
Occupational Safety and Health Administration (OSHA)
The federal regulatory compliance agency that develops, publishes, and enforces guidelines concerning safety in the workplace.
A woman who has had 3 other children is in active labor. She tells you that she is having severe lower back pain. The most likely cause is..?
The fetus is presenting posteriorly and is putting pressure on her spine
Cardiac arrest
The heart and breathing stop suddenly and without warning
EMTs may transport patients from ____ to ____
The hospital to the patient's home, the scene of an emergency to the hospital, one hospital to another hospital.
designated officer
The individual in the department who is charged with responsibility of managing exposures and infection control issues.
Which of the following best explains the significance of greenish colored amniotic fluid? It is atypical, but nothing to worry about. The infant requires aggressive suctioning as soon as the head is delivered. The fetus died during the last trimester and the mother must be advised of this. It is an indication of abruption placentae
The infant requires aggressive suctioning as soon as the head is delivered
patient care report (PCR)
The legal document used to record all patient care activities. This report has direct patient care functions but also administrative and quality control functions. PCRs are also known as prehospital care reports.
You and your partner Grimes are called to the scene of a stabbing. There are two patients reported. A woman with a stab wound to the URQ and a man with a stab wound to the LRQ. The woman with the wound in the URQ is having problems breathing, has a pulse of 103, respirations of 35, and they are shallow. The patient with the stab wound to the LRQ is complaining of severe abdominal pain and has a pulse of 48 and a respiration rate of 24. Which patient is most likely to have a low blood pressure? Why?
The man, because of the nature and location of the injury, he may be losing blood internally. His pulse is too slow as well
applied ethics
The manner in which principles of ethics are incorporated into professional conduct.
What is the myocardium?
The muscle around the heart
What is a trade name of a medication?
The name under which a specific company markets its brand
host
The organism or individual that is attacked by the infecting agent.
All of the following are signs of an adequate airway except:
The patient is fully conscious.
Which of the following is an appropriate situation in which to use an emergency move?
The patient is in danger of fire When there is potential for violence When a non-critical patient is blocking access to a critical patient
Which of the following applies to expressed consent or refusal of medical care? The patient must be informed of the risks, benefits, and alternatives available to the proposed treatment The patient's family must also agree to treatment or refusal of treatment If the patient agrees to treatment, his or her understanding of the treatment offered is implied Once the patient consents to treatment, he or she is obligated to complete the treatment offered.
The patient must be informed of the risks, benefits, and alternatives available to the proposed treatment
Under which of the following circumstances may a written patient care report be released? The patient provides written permission It is requested by an attorney The patient is deceased All of the above
The patient provides written permission
Which of the following is true of treating cold injuries to the extremities? Fingers and toes should be rubbed vigorously. Cold water should be run over the extremity. Encourage the patient to walk on cold injured feet. The patient should be handled gently.
The patient should be handled gently
What is the peritoneum? What are the two types and their function?
The peritoneum is the thin membrane lining the abdominal cavity and covering each organ Visceral: covers each organ Parietal: lines the abdominal cavity
discovery
The phase of a civil suit where the plaintiff and defense obtain information from each other that will enable the attorneys to have a better understanding of the case, which will assist them in negotiating a possible settlement or in preparing for trial. Discovery includes depositions, interrogatories, and demands for production of records.
ethics
The philosophy of right and wrong, of moral duties, and of ideal professional behavior.
contamination
The presence of infectious organisms on or in objects such as dressings, water, food, needles, wounds or a patients body.
Centers for Disease Control and Prevention (CDC)
The primary federal agency that conducts and supports public health activities in the US. The CDC is part of the US Department of Health and Human Services.
emergency doctrine
The principle of law that permits a health care provider to treat a patient in an emergency situation when the patient is incapable of granting consent because of an altered level of consciousness, disability, the effects of drugs or alcohol, or the patient's age.
licensure
The process whereby a competent authority, usually the state, allows individuals to perform a regulated act.
Respiratory Failure
The reduction of breathing to the point where oxygen intake is not sufficient to support life
patient autonomy
The right of a patient to make informed choices regarding his or her health care.
kidnapping
The seizing, confining, abducting, or carrying away of a person by force, including transporting a competent adult for medical treatment without his or her consent.
airborne transmission
The spread of an organism in aerosol form.
Which of the following statements regarding the different stages of the grieving process is correct?
The stages of the grieving process may occur simultaneously.
What determines the EMT's scope of practice?
The state in which the EMT practices.
bioethics
The study of ethics related to issues that arise in health care.
proxemics
The study of space between people and its effects on communication.
perfusion
The supply of oxygen to and removal of wastes from the cells and tissues of the body as a result of the flow of blood through the capillaries.
statute of limitations
The time within which a case must be commenced.
vital capacity
The total volume of air that can be exhaled after maximal inhalation.
communication
The transmission of information to another person—verbally or through body language.
paging
The use of a radio signal and a voice or digital message that is transmitted to pagers ("beepers") or desktop monitor radios.
vector-borne transmission
The use of an animal to spread an organism from one person or place to another.
transmission
The way in which an infection disease is spread : contact, airborne, by vehicles, or by vectors.
You and your partner Paulina are called to the scene of a stabbing. There are two patients reported. A woman with a stab wound to the URQ and a man with a stab wound to the LRQ. The woman with the wound in the URQ is having problems breathing and has a pulse of 103, respirations of 35, and they are shallow. The patient with the stab wound to the LRQ is complaining of severe abdominal pain and has a pulse of 60 and a respiration rate of 24. Which patient probably has a pneumothorax? Why?
The woman, because the injury is a penetrating wound to the lung area
documentation
The written portion of the EMT's patient interaction. This becomes part of the patient's permanent medical record.
Which of the following statements regarding HIV is correct?
There is no vaccine against HIV infection.
Which of the following statements regarding epinephrine auto-injectors is true? They are available over the counter They are carried on the ambulance for use in patients with or without prior allergic reactions They are available in adult and pediatric dosages They can be used to prevent an allergic reaction if exposure to an allergen is anticipated
They are available in adult and pediatric dosages
Which of the following statements concerning tourniquets is true? EMTs are never permitted to use tourniquets. Tourniquets are generally contraindicated for bleeding below (distal to) the knee or elbow. Tourniquets are now favored as the first method of bleeding control for all arterial bleeding. Tourniquets must never be used with penetrating trauma.
Tourniquets are generally contraindicated for bleeding below (distal to) the knee or elbow.
medial
Toward center of body
Which statement best describes the function of platelets in the body?
They are the main factor in forming blood clots
Which of the following applies to fractures that are caused by disease rather than injury? They are treated the same as fractures due to injury They are treated differently than fractures caused by injury They should not be treated at all They never occur in emergency patients
They are treated the same as fractures due to injury
You arrive on scene to find a male patient alone and suffering from Aphasia. Blood pressure is 110/70, respirations are 18, and pulse is 82. SpO2 sat is 98%. Getting a history from this patient will be difficult because?
They cannot understand or produce speech
What are 3 physiological differences in the pediatric airway?
They have a proportionally larger tongue, smaller nose and mouth, and smaller trachea
Glasgow scale
This is an assessment tool used to determine consciousness in clients. The Score of 15 reveals a fully oriented person. 3 is deep coma., Used for head trauma- Score 3-15, based on Eye opening, Verbal response and Motor response.
Physical exam, Baseline vitals, History
Three major steps in secondary assessments
When can I apply a splint on scene
To extremity fractures only if the patient is stable and there is no life threat
The integumentary system refers to what?
To the skin, nails, hair, and sweat glands
Hypercapnia
Too much carbon dioxide
Rewarming affected parts by immersing in warm water should only be done in the prehospital setting if which of the following criteria is met? It is a late or deep cold injury The injury is superficial Transport is long or delayed A physician is on the scene
Transport is long or delayed
You arrive at the scene of a motor vehicle versus pedestrian accident. The patient, a 13-year-old male, is unconscious and had multiple injuries. As you are treating the child, a law enforcement officer advises you that the child's parents will be at the scene is approximately 15 minutes. What should you do?
Transport the child immediately and have the parents meet you at the hospital
If an infant is crowning but undelivered after 10 minutes, what is the most appropriate next step? Gently stretch the vaginal opening to facilitate delivery. Insert your gloved hands on either side of the infant's head and apply gentle traction to facilitate delivery. Transport the mother to the hospital without further delay, but do not attempt to manually facilitate delivery. Wait up to an additional 10 minutes before taking any action.
Transport the mother to the hospital without further delay, but do not attempt to manually facilitate delivery
septic shock treatment
Transport, ventilation, oxygen, elevate legs and keep warm
What are 4 signs of inadequate breathing in adults?
Tripod, accessory muscle use, tachycardia, stridor
True or false: a patient with respiratory failure will require manual mechanical ventilations
True
True or false: an airway that is open and free of obstruction is referred to as being patent
True
True or false: arteries carry oxygen-rich blood away from the heart while veins transport oxygen-depleted blood towards the heart
True
True or false: hypoxia occurs when oxygen does not reach the bloodstream
True
True or false: the muscles of respiration contract during respiration
True
True or false: when you are communicating with a patient, body language can either set your patient at ease or make him or her uncomfortable or uncooperative.
True
Stop ambulance when using aed
True and shut off engine
True or false: It is important to consider the emotional support of the patient's family when making decisions on whether or not to resuscitate a patient.
True. It is important to consider the family when clinical decisions of whether or not to resuscitate a patient are being made. They will need emotional support from the EMT.
What is status epilepticus?
Two or more seizures in a row without regaining consciousness or a single seizure lasting more than 10 minutes
What are two types of diabetes mellitus? Explain
Type 1: pancreatic cells do not function properly and insulin is not secreted normally (needs glucose) Type 2: body's cells fail to utilize insulin properly because they cannot move glucose into cells (needs insulin)
implied consent
Type of consent in which a patient who is unable to give consent is given treatment under the legal assumption that he or she would want treatment.
Nuchal cord
Umbilical cord around the neck; assess by as soon s the head is out of the vagina, run index finger around the neck; if unable to stretch over the babies head, clamp cord 2" apart and cut, then deliver as normal.
Under what conditions can confidential patient information be released to someone not directly involved in the patient's care?
Under state law, the case involves a reportable situation such as a gunshot wound. A subpoena has been issued for the information. The patient signs a written release requesting the release of information.
abandonment
Unilateral termination of care by the EMT without the patient's consent and without making provisions for transferring care to another medical professional with the skills and training necessary to meet the needs of the patient.
Umbilical cord blood vessels
Unique cause they do opposite Veins bring oxygen blood Arteries bring deoxygenated blood
assault
Unlawfully placing a patient in fear of bodily harm.
What is stridor?
Upper airway obstruction that sounds high pitched on inspiration
You arrive on the scene of a motor vehicle collision. Your patient remains in the vehicle and has a weak, rapid pulse and ineffective respirations. Which type of movement should you use to remove the patient from the vehicle?
Urgent
As you approach the scene of a motor vehicle collision you can see that a tanker truck is on its side. Which of the following should you do? Park down-wind from the truck Immediately remove patients and bystanders from the area Use binoculars to read the placard on the truck Check the truck's bill of lading
Use binoculars to read the placard on the truck
Which of the following is a sign of increased respiratory effort? Shallow breathing Use of neck muscles Cyanosis Decreased respiratory rate
Use of neck muscles
Glasgow coma scale
Used for head trauma- Score 3-15, based on Eye opening, Verbal response and Motor response.
When communicating with patients what should you avoid?
Using nicknames or terms of endearment, speaking quickly, and using medical terminology.
Which of the following structures is the site of development of the fetus throughout pregnancy? Placenta Uterus Ovary Fallopian tube
Uterus
MED channels
VHF and UHF channels that the Federal Communications Commission has designated exclusively for EMS use.
The fundamental pathophysiology of the immune systems response to allergens include all of the following
Vasodilation Bronchoconstriction Increased capillary permeability
What would you do if a newborn infant has a heart rate lower than 100 beats a minute?
Ventilate at 40-60 breaths a minute
The most important treatment when caring for a patient with an irritant gas exposure is?
Ventilation
systole BP
Ventricles contract and create force that pushes blood through vessels; pressure of blood leaving heart
Chaotic electrical activity originating from many sites in the heart is called:
Ventricular fibrillation
Half of all cardiac arrest patients will initially have a _______ rhythm.
Ventricular fibrillation
The primary electrical disturbance that results in cardiac arrest is...
Ventricular fibrillation
V-tach
Ventricular tachycardia (an increased ventricular heart rate).
therapeutic communication
Verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship.
Ribs
Vertebrosternal = 'True ribs" -ribs 1-7 attach directly to the sternum through their costal cartilage. Vertebrochondral = "False ribs" =ribs 8-10 costal cartilage articulate indirectly with the sternumb by joing the costal cartilages of ribs above. Vertebral Ribs = "Floating ribs" ribs 11 and 12 no anterior attachment.
You recently noticed that you are irritated with your spouse, children, and just about everyone. You are not sleeping well, and find it difficult to sit through movie, which is usually an enjoyable activity for you. Which of the following is most likely to be helpful? Request a couple of overtime shifts to avoid conflict with your family Walk a mile or so before or after your shift and on your days off Have a beer or glass of wine to help you relax and fall asleep Call in sick for your next shift
Walk a mile or so before or after your shift and on your days off.
Glucose and sodium bring what with them?
Water
Good indicator of internal blood loss
Weak pulse the into fast pulse Also no radial pulse body brings blood to core
Your patient has signs and symptoms suggestive of tuberculosis. He is coughing and needs oxygen. What action is most appropriate in protecting yourself from exposure to tuberculosis?
Wear a HEPA mask or N-95 respirator and gloves.
You have been dispatched to respond for a sick person. Which of the following best describes the appropriate actions regarding the use of BSI? Wear gloves before examining the patient regardless of the patient's condition Wear gloves only if there are visible body fluids present Wear gloves only if you have cuts or scrapes on your hands Gloves are not required as long as you practice good hand-washing after patient contact
Wear gloves before examining the patient regardless of the patient's condition
. An EMT would use the AVPU scale to evaluate_____________________ and an EMT would use the GCS scale in order to see_________________________________.
What stimulus it takes to get a reaction / what response is given for each different stimulus
Scope of Practice
What we are allowed to do or trained to do
Most violent injuries to EMT's occur?
When a patient has a sudden behavioral change
ethnocentrism
When a person considers his or her own cultural values as more important when interacting with people of a different culture.
cultural imposition
When one person imposes his or her beliefs, values, and practices on another because he or she believe his or her ideals are superior.
res ipsa loquitor
When the EMT or an EMS service is held liable even when the plaintiff is unable to clearly demonstrate how an injury occurred.
Expulsion stage
When the baby is expelled from its mother's body
do not resuscitate (DNR) orders
Written documentation by a physician giving permission to medical personnel to not attempt resuscitation in the event of cardiac arrest.
advance directive
Written documentation that specifies medical treatment for a competent patient should the patient become unable to make decisions; also called a living will or health care directive.
standing orders
Written documents, signed by the EMS system's medical director, that outline specific directions, permissions, and sometimes prohibitions regarding patient care; also called protocols.
interrogatories
Written questions that the defense and plaintiff send to one other.
standard of care
Written, accepted levels of emergency care expected by reason of training and profession; written by legal or professional organizations so that patients are not exposed to unreasonable risk or harm.
Can I aed on 1-8 year olds
Yes but prefer to use less electrical dose If u can't it is ok
What is the best general course of action when a competent adult patient wants to refuse your care?
You should inform the patient of the potential risks of refusing treatment.
You and your partner Monroe arrive on scene to a house fire that has just been put out. You are treating a female patient with a full thickness burn to her leg. Which of the burn zones is the one most likely to recover?
Zone of hyperemia
fowler position
a bed sitting position with the head of the bed raised to 45 degrees
Thrombus
a blood clot formed within a blood vessel and remaining attached to its place of origin
Full thickness burn
a burn in which all the layers of the skin are damaged. There are usually areas that are charred black or areas that are dry and white. Also called a third-degree burn.
Partial thickness burn
a burn in which the first layer of skin (epidermis) is burned through and the dermis (second layer) is damaged. Burns of this type cause reddening, blistering, and a mottled appearence. (Also called second-degree burn).
Superficial burn
a burn that involves only the epidermis, the outer layer of the skin. It is characterized by reddening of the skin and perhaps some swelling. An example is a sunburn. Also called a first-degree burn.
pneumothorax
a collection of air or gas in the pleural space causing the lung to collapse; sudden pain, tightness in chest, shortness of breath, rapid heart rate and breathing, cough, fatigue; esp. in tall thin males and ppl w/ asthma
Status epilepticus
a condition in which there are continuing attacks of epilepsy without intervals of consciousness
Abruptio placentae
a disorder of pregnancy in which the placenta prematurely separates from the wall of the uterus
Advanced Directive
a legal document prepared by a living, competent adult to provide guidance to the health care team if the individual should become unable to make decisions regarding his or her medical care; may also be called a living will or durable power of attorney for health care
Emergency Move
a move made when there is an immediate danger to the patient.
Hypothalamus
a neural structure lying below the thalamus; directs eating, drinking, body temperature; helps govern the endocrine system via the pituitary gland, and is linked to emotion
Which of the following scenarios most accurately depicts abandonment?
a paramedic transfers patient care to an EMT
Which of the following general statements regarding consent is most correct?
a patient can consent to transport but can legally refuse to be treated
cheyne-stokes
a pattern of alternating periods of apnea & hyperpnea; associated w/ heart failure, stroke, CO poisoning
Good Samaritan
a person who voluntarily offers help or sympathy in times of trouble
Tension pneumothorax
a pneumothorax with rapid accumulation of air in the pleural space causing severely high intrapleural pressures with resultant tension on the heart and great vessels
In which of the following situations does the EMT not have a legal duty to act?
a response to a motor vehicle crash while off duty
exposure
a situation in which a person has had contact with blood, body fluids, tissues, or airborne particles in a manner that suggests disease transmission may occur.
Syncope
a sudden, and generally temporary, loss of consciousness and postural tone, due to inadequate flow of oxygenated blood to the brain (fainting)
Emergency medical services are..
a team of health care professionals who are responsible for providing emergency care and transportation to the sick and injured
Eclampsia
a toxic condition characterized by convulsions and possibly coma during or immediately after pregnancy
Peritoneum
a transparent membrane that lines the abdominal cavity in mammals and covers most of the viscera
Embolic stroke
a type of ischemic stroke that causes a clot to travel to the brain, mostly from the left side of the heart
pleural effusion
abnormal accumulation of fluid in the pleural space
A PASG is contraindicated if the patient presents with cardiogenic shock or _______.
abnormal lung sounds
Preeclampsia
abnormal state of pregnancy characterized by hypertension and fluid retention and albuminuria
adrenal gland
above kidneys, fight or flight (epinephrine, norepinephrine)
asytole
absence of all heart electrical activity
Apnea
absence of breathing
A patient has had skin exposure to a toxin. What is the route of entry for the toxin?
absorption
jejunum
absorption of digestive products. lots of surface area
The final stage of death and dying is MOST commonly displayed as:
acceptance..
You are transporting an elderly woman who has possibly experienced a stroke. She is obviously scared but is unable to talk and cannot move the entire right side of her body. In addition to providing the medical care that she needs, you should:
acknowledge that she is scared and tell her that you are going to take good care of her.
When caring for the parents of a child who has died of leukemia, the EMT should:
acknowledge the death of their child in private.
human immunodeficiency virus (HIV)
acquired immunodeficiency syndrome (AIDS) is caused by HIV, which damages the cells in the body's immune system so that the body is unable to fight infection or certain cancers.
The BEST way to reduce your risk of contracting a work-related disease following exposure is to:
activate your department's infection control plan as soon as possible..
acute myocardial infarction
actual death of cells (more likely in left ventricle) Generally increased pulse, respirations and BP
Pneumonia
acute inflammation and infection of alveoli, which fill with pus or products of the inflammatory reaction
thromboembolism in coronary artery
acute myocardial infarction
AMI
acute myocardial infarction (heart attack)
epinephrine
adrenaline; activates a sympathetic nervous system by making the heart beat faster, stopping digestion, enlarging pupils, sending sugar into the bloodstream, preparing a blood clot faster
how long to suction
adult: 15 sec child: 10 sec infant: 5 sec
A 15-year-old boy was killed when he was struck by a car while riding his bicycle. He has numerous disfiguring injuries and has been placed in the back of the ambulance to shield him from curious bystanders. When the child's parents arrive at the scene, they demand to see him. You should:
advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first.
Special considerations in infant and child airways include: Smaller structures more easily obstructed Tongue and head proportionally larger Softer cartilage easily kinked if hyperflexed or extended all of the above
all of the above
What are the signs and symptoms of a possible injury to the spinal cord? loss of feeling in the arms or legs inability to move the arms or legs pain over the spine all of the above
all of the above
Which of the following is assessed in the ongoing assessment? mental status vital signs effectiveness of interventions all of the above
all of the above
Which of the following should be done after administering a medication to a patient? Document the name of the medication, the dose, and the route. Recheck vital signs Ask the patient about effects and side effects of the medication all of the above
all of the above
ASA: Contraindications
allergy, bleeding disorder, already taken 324mg
Glucagon: Contraindications
allergy, hx of pheochromocytoma (tumor which secretes epinephrine)
When decontaminating the back of your ambulance after a call, you should:
allow surfaces to air dry unless otherwise indicated in the product directions
preload
amount of blood returning to the heart
Which of the following scenarios most accurately depicts informed consent?
an EMT advises a patient of the risk of receiving treatment
A thrombus which has broken loose, moving with blood flow, is called
an embolism
Duty to Act
an obligation to provide care to a patient
Epidermis
an outer layer of cells designed to provide protection
acetaminophen/ tylenol
analgesic/anti-fever for relief of mild pain/fever, headache, muscle aches don't take if : hypersensitivity bc allergic rxn (500-1000mg/4 hours)
A weakened section of an arterial wall that begins to dilate is known as a(n)
aneurysm
You and your partner respond to the residence of a 66-year-old male with shortness of breath. As you are assessing the patient, his wife tells you that he was recently diagnosed with lung cancer. The patient is verbally abusive and tells you that failure of the health care system caused his disease. What stage of the grieving process is this patient's behavior consistent with?
anger
Vector-borne transmission of an infectious organism occurs via:
animals or insects.
As an EMT, the performance or your duties will be compared to that of:
another EMT
diphenhydramine/benadryl
antihistamine for mild allergic rxns don't take if: asthma, glaucoma, pregnancy, hypertension, infant causes: sleepiness, dry mouth/throat (25-50 mg)
Neurological deficit
any deficiency in the nervous system's functioning, typically exhibited as a motor, sensory, or cognitive deficit
embolus
anything in the circulatory system that moves from its point of origin to a distant site and lodges there, obstructing subsequent blood flow in that area
stroke to left hemisphere
aphasia and right body paralysis
You are transporting a 40-year-old male with respiratory distress. The patient tells you that he recently had a positive tuberculosis (TB) skin test and is currently being evaluated for possible TB. You should:
apply a nonrebreathing mask on the patient and a high-efficiency particulate air (HEPA) respirator on yourself..
During your monthly internal quality(QI) improvement meeting, you review several patient care reports(PCRs) with the staff of your EMS system. You identify the patient's name, age, and sex, and then discuss the treatment that was provided by the EMTs in the field. By taking this approach to the QI process, you:
are in violation of HIPPA because you did not remove from the PCR beforhand
When gases enter the bloodstream as the result of a damaged lung, it is called a(n)
arterial gas embolism
Before giving any medication, you should:
ask about allergies, get a complete set of vital signs, ask about other medications the patient is taking, and ask the five rights of medication: right patient, right route, right dose, right drug, right time.
Acting in such a way as to make another person fear immediate bodily harm is called:
assault
You are the first to arrive on the scene of a school bus that has collided with a tractor-trailer on a stretch of rural interstate highway. Of the following, what should you do first? begin triage free any entrapped victims establish incident command assess the need for additional resources
assess the need for additional resources
A patient regains consciousness en route from his office to the emergency department. The patient tells you that he feels fine and does not want to go to the hospital. Under these circumstances, you should:
assess whether or not the patient's mental condition is impared
According to the National EMS Scope of Practice Model, an EMT should be able to ...?
assist a patient with certain prescribed medications
In the condition called ____, there is not electrical stimulus to cause the heart muscle to contract.
asystole
Which of the following situations requires you to notify the appropriate authorities?
attempted suicide
type 1 diabetes
autoimmune problem; the body becomes allergic to and destroys insulin-producing cells of the endocrine glands in the pancreas
inferior
away from the head or below point of reference
emphysema
barrel chest, pursed lip breathing, dyspnea on exertion
You have been tasked by your director to assist in the development of your EMS agency's institutional standards. When developing these standards, it is important to:
be reasonable and realistic to avoid overburdening your personnel
When faced with a situation in which a patient is in cardiac arrest, and a valid living will or DNR order cannot be located you should:
begin resuscitation at once
You respond to the home of a 59-year-old man who is unconscious, has slow, shallow breathing, and has week pulse. The family states that the patient has terminal brain cancer and does not wish to be resuscitated. They further state that there is a DNR order for this patient; however, they are unable to locate it. You should:
begin treatment and contact medical control as needed
When you and your partner arrive at the residence of a man in cardiac arrest, you immediately recognize the patient as the drunk driver who killed your brother several years earlier. A backup ambulance is en route to the scene. You should:
begin two-rescuer CPR and apply the automated external defibrillator(AED) as soon as possible
Simple partial seizures
begins in one area can move, patient aware and conscious, expreience change in taste/smell cause nausea
simple partial seizure
begins in one part of the brain, causes numbness, weakness, dizziness. no change in consciousness. twitching of muscles and extremities, can spread slowly from one part of body to another. sometimes brief paralysis
When a patient is dying, he or she may experience regression. This is MOST accurately defined as:
behavior consistent with an earlier developmental stage.
Which of the following is a risk factor for suicide? being divorced being female having a large family age 30 or younger
being divorced
Sublingual
beneath the tongue
tonic-clonic seizure
bilateral movement from muscle rigidity (tonic) to relaxation (clonic) *tachycardia, hyperventilation, sweating, salivation followed by postictal state (5-30 mins) regaining consciousness gradually.
Carbon monoxide blocks the ability of the blood to oxygenate the body because it:
binds with the hemoglobin in the red blood cells.
cystitis
bladder inflammation, common in women, usually caused by bacterial infection (UTI), lower quadrant pain, urgency and frequent urination
Epistaxis
bleeding from the nose
Pulmonary embolism
blockage of the pulmonary artery by foreign matter or by a blood clot
White blood cell
blood cell that functions in defending the body against infections and cancer cells; also called a leukocyte
ischemic stroke
blood flow is blocked from a part of the brain with a clotted vessel (symptoms: loss of movement on side of body opposite from side where blockage occurred) (80% of strokes)
hemothorax
blood in pleural space
paradoxus pulsus
blood pressure declines as one inhales and increases as one exhales
an inflammation of the bronchi (medium-size airways) in the lungs
bronchitis
BVM
can deliver 100% oxygen
anaphylactic shock signs/symptoms
can develop w/in seconds, itching/rash, burning skin, vascular dilation, generalized edema, coma, rapid death
Small round purplish spots, called petechiae, are caused by:
capillary bleeding
Hazards that are associated with a structural fire include all of the following, EXCEPT:
carbon dioxide deficiency.
Hospice care refers to which of the following? rehabilitation care care for the terminally ill care in the hospital eyes and ears care
care for the terminally ill
The spread of HIV and hepatitis in the health care setting can usually be traced to:
careless handling of sharps..
What vessel supplies blood to the head and brain?
carotid arteries
Pulmonary arteries
carry deoxygenated blood out of the right ventricle and into the lungs
arteries
carry oxygenated blood to body (except pulmonary)
hyperventilation
caused by hyperglycemia, aspirin OD, severe infection (compensation for acidosis)
right lower quadrant
cecum, ascending colon, appendix
determine need for BLS
check responsiveness, breathing and then carotid pulse
If you are unable to obtain a patient's radial pulse, you should immediately
check the carotid pulse
kidney stones
chemicals crystallize urine. if pass through ureter, can cause blockage --> swelling of kidney. discomfort in flank becomes intense and radiates to groin
Angina pectoris
chest pain caused by a temporary loss of oxygenated blood to heart muscle often caused by narrowing of the coronary arteries
NTG: Indications
chest pain of cardiac origin, angina, acute CHF
cardiogenic shock signs/symptoms
chest pain, irregular pulse, weak pulse, low BP, cyanosis, cool/clammy skin, anxiety, rales, pulmonary edema
Epilepsy
chronic brain disorder characterized by recurrent seizure activity
___ ___ is part of a syndrome called chronic obstructive pulmonary disease (COPD)
chronic bronchitis
bronchitis
chronic cough, wheezing, cyanosis, productive cough
COPD
chronic obstructive pulmonary disease; chronic bronchitis - bronchiole lining inflamed, excess mucus formed; emphysema - walls of alveoli break down; HYPOXIC DRIVE (not in asthma)
If it is not possible to adequately clean your ambulance at the hospital following a call, you should:
clean the ambulance at your station in a designated area that is well ventilated
Cerebrospinal fluid
clear liquid produced in the ventricles of the brain
In order for a do not resuscitate(DNR) order to be valid, it must:
clearly state the patient's medical prblem
Occluded
closed off
Which hollow organ is found in all four quadrants of the abdomen?
colon
An example of a prevention strategy is..
community awareness programs that emphasize the dangers of drinking and driving
V-fib
completely erratic rhythm with no identifiable waves; fatal
Aortic aneurysm
congenital or developed weakness in wall of lower lumbar region (aorta), balloons out, anterior abdominal wall pulses, untreatable if ruptures
causes of seizures
congenital, tumor, infection, scar tissue, head trauma, stroke, hypoxia, hypoglycemia, poison, drug OD, withdrawal, high fever
rhonchi
congested breath sounds that may suggest presence of mucus in lungs
ligament
connects bone to bone
tendon
connects muscle to bone
Online Direction
consists of orders from the on-duty physician given directly to an EMT-B in the field by radio or telephone.
Offline Direction
consists of standing orders issued by the medical director that allows EMTs to give certain medications or perform certain procedures without speaking to the medical director or another physician.
While transporting a woman with diabetes, you inadvertently give her oral glucose even though her blood glucose level was high. You reassess the patient and note that her condition did not change; she remained stable. You should:
contact medical control and notify him or her of the error
If an EMT candidate has been convicted of a felony or misdemeanor, he or she should..?
contact the state EMS office and provide them with the required documentation
Ruq
contains majority of liver, gallbladder, small portion of pancreas, right kidney, small intestines, and colon.
Llq
contains parts of the small and large intestines, left ovary, left fallopian tube, left ureter
Rlq
contains parts of the small and large intestines, right ovary, right fallopian tube, appendix, right ureter
While transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. Your most appropriate action should be to:
continue transporting your patient and notify the dispatcher of the crash
Status epilepticus refers to:
continuous seizure activity
A reason that a medication normally used to treat a patient's condition would be withheld is referred to as a:
contraindication
Febrile seizure
convulsions brought on by a fever in infants or small children. During a febrile seizure, a child often loses consciousness and shakes, moving limbs on both sides of the body.
In a patient with poor perfusion, the most likely skin findings would be:
cool, moist, and pale.
kidney infection
costovertebral angle pain
pertussis (whooping cough)
coughing spells, whooping sound, fever (usually pediatric)
You are assessing a woman who was thrown from her horse. She is located in a large field and you can see that a thunderstorm is rapidly approaching. Suddenly, you feel your skin begin to tingle and the hair on your arms stands on end. The ambulance is located about 30 yards away. You should:
crouch down in a position so that only your feet are touching the ground.
What type of stress reaction occurs when an EMT is exposed to many insignificant stressors over a period of several months or years?
cumulative stress reaction.
cartilage
cushion between bones
Aortic Dissection
damage may result in fatal bleeding, dissection is a condition where the inner layer of the wall of the aorta begins to tear; patient may complain of pain in the chest, abdomen or back will exhibit signs of shock
neurogenic shock cause
damaged c spine (blood vessel dilation)
Putrefaction is defined as:
decomposition of the body's tissue
A late sign of shock is:
decreased blood pressure
Hypoxia
deficient amount of oxygen in tissue cells
Determination of exposure is an important component of an infection control plan because it:
defines who is at risk for contact with blood and body fluids and which tasks pose a risk of exposure..
DCAP-BTLS
deformities, contusions, abrasions, penetrations, burns, tenderness, lacerations, swelling
DCAP-BTLS =
deformities, contusions, abrasions, punctures, burns, tenderness, lacerations, swelling
Pulmonary veins
deliver oxygen rich blood from the lungs to the left atrium
You are caring for a 35-year-old female with pregnancy-related complications. She is clearly experiencing significant stress and is crying uncontrollably. Your MOST appropriate action would be to:
demonstrate courtesy and speak with a professional tone of voice.
It is especially important for EMS personnel to develop nonadversarial relationships with their coworkers because they
depend on each other for their safety.
congestive heart failure
dependent edema, rales, paroxysmal nocturnal dyspnea, JVD, shortness of breath always
You arrive at the scene of an apparent death. When evaluating the patient, which of the following is a defective sign of death?
dependent lividity
left lower quadrant
descending and sigmoid portions of colon
basket stretcher
designed to surround and protect the patient, this stretcher is used to move a patient from one level to another to over rough terrain.
psychogenic shock treatment
determine duration of unconsciousness, record initial vital signs and mental status, suspect head injury and transport
Which of the following most accurately defines negligence?
deviation from the standard care that may result in further injury
The dome-shaped muscle that participates in breathing is the:
diaphragm
An EMT would most likely be held liable for abandonment if he or she:
did not make provisions for continued care of an injured patient
pulse pressure
difference between systolic and diastolic pressure no more than 25%
Dyspnea
difficult or labored respiration
duodenum
digestive juices from the pancreas and liver mix together
Your patient's right pupil is much larger than the left and does not get smaller in response to light. The right pupil is best described as:
dilated and nonreactive
The action of Nitroglycerin is that it:
dilates the coronary arteries
ventricular fibrillation
disorganized, ineffective quivering of the ventricles
Common factors that influence how a patient reacts to the stress of an illness or injury include all of the following, EXCEPT:
distrust of the EMT.
What type of consent is involved when a 39-year-old mentally competent female with a severe headache asks you to take her to the hospital?
expressed
You suspect that a pregnant 16-year-old girl has broken her leg after she was hit by a car. You explain that you plan to splint her leg, and she agrees to treatment. What type of consent is her agreement considered?
expressed
anaphylactic shock cause
extreme life-threatening allergic rxn
stroke signs and symptoms
facial dropping, weakness/numbness, loss of movement/sensation, lack of muscle coordination (ataxia), vision loss in one eye, difficulty swallowing, decreased responsiveness, speech disorders (dysphasia), difficulty expressing thoughts/inability to speak (expressive aphasia), slurred speech (dysarthria), difficulty understanding others (receptive aphasia), severe headache, loss of balance, confusion, dizziness, weakness, restlessness, combativeness, coma
True or false: A falling blood pressure is one of the earliest signs of shock (hypoperfusion)
false
The hepatitis B vaccine program, a component of the infection control plan, addresses all of the following issues, EXCEPT:
family history of hepatitis..
When considering his or her personal life, it is important for the EMT to realize that:
family or friends may not understand the stress associated with EMS.
shock position
feet elevated 12 inches higher than head
Your patient's skin feels hot to the touch. The most likely cause is
fever
croup
fever, barking cough (usually pediatric)
Pericardial tamponade
filling of the pericardial sac with fluid, which in turn limits the filling and function of the heart.
Full dilation of the cervix occurs in the _______ stage of labor.
first
Dilation stage
first stage of labor; the uterine muscle contracts strongly to expel the fetus; the fetus presses on the cervix and causes it to dilate or expand
right heart failure
fluid backs up into body = swelling in feet and legs (dependent edema)
anaphylaxis
flushed skin/hives, generalized edema, decreased BP, laryngeal edema w/ dyspnea
You and your partner arrive at the scene of a motor vehicle crash. The driver, a young male, is severely entrapped in his car. He has an open head injury and massive facial trauma. He is unresponsive, is not breathing, and does not have a palpable carotid pulse. You should:
have your partner check for a pulse to confirm that the patient is deceased
Which body parts are considered to be 9% of total body surface area
head, chest, abdomen, both arms, each leg
NTG: Side Effects
headache, hypotension, tachycardia
hypertensive emergency symptoms
headache, strong bounding pulse, ringing in ears, nausea and vomiting, dizziness, warm skin, nosebleed, altered mental status, sudden development of pulmonary edema
angina pectoris
heart tissues don't get enough oxygen for a short time (pain goes away when increased oxygen demand goes away)
polydipsia
frequent drinking of liquid to satisfy continuous thirst
Which of the following signs and symptoms are NOT consistent with hypoglycemia? rapid onset frequent urination cool, clammy skin seizures
frequent urination
Coffee ground emesis is a sign of which problem?
gastrointestinal bleeding
Grand mal
generalized tonic-clonic (it is sudden cry, fall, rigidity, followed by muscle jerking; shallow, irregular breathing; possible loss of bladder or bowel control; usually lasts seconds to minutes, followed by some confusion, a period of sleep (postical lethargy), and then return to full consciousness.
tracheostomy dysfunction
goal is patent airway (suction mucus and secretions)
hyperglycemia signs/symptoms
gradual onset, warm/dry skin, infection is common, intense thirst, vomiting, kussmaul respirations, sweet/fruity breath, rapid/weak/thready pulse, restless, abnormal/slurred speech, gradual response to treatment, normal to low BP
acute coronary syndrom
group of symptoms caused by myocardial ischemia. (angina pectoris or acute myocardial infarction)
Vaccination against the hepatitis A virus is unnecessary if you:
have been infected in the past.
If a person is partially immune to a particular disease, he or she:
may develop illness from germs that lie dormant from the initial infection.
Which of the following best characterizes Type 1 diabetes? insulin dependent non-insulin dependent overweight onset in adulthood
insulin dependent
internal vs external respiration
internal: exchange of CO2 and O2 within circulatory system and body cells
cerebrovascular accident (CVA) or stroke
interruption of blood flow to the brain resulting in loss of brain function
Intramuscular
into the muscle
A hematoma within the brain is classified as which of the following? epidural subdural intracerebral subarachnoid
intracerebral
In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor:
is self-supporting and lives by him- or herself
Which of the following signs would indicate that your partner is experiencing significant stress?
isolation from the rest of the crew.
If an action or procedure that was performed on a patient is not recorded on the written report:
it was not performed in the eyes of the law
trendelenburg's position
keep blood in core of body
hyperglycemic crisis (diabetic coma)
ketoacidosis, hyperglycemia, dehydration
retroperitoneal organs
kidneys and pancreas
ataxia
lack of muscle coordination
cerebrum
large part of the brain that controls the senses and thinking
Which of the following factors is NOT taken into consideration when assessing a person's potential for violence?
large physical size
The voice box is also known as the:
larynx
stroke to right hemisphere
left body paralysis, understand works but have dysarthria
development of CHF
left ventricle pump damage leads to heart rate increase and left ventricle enlargement in effort to increase amount of blood pumped. When these adaptations no longer make up for decreased heart function, CHF develops. Lungs become congested w/ fluid
Two EMT's witnessed a call in which a coworker gave adequate medical care but ignored the patient's emotional needs. The coworker was deliberately rude solely because the patient was thought to be infected with the human immunodeficiency virus(HIV). The EMT's ignored the coworker's treatment of this patient and took no steps to prevent this behavior from happening again. This lack of action on the part of the two EMT's is considered
legal but unethical
Distributive shock
less distribution of blood to areas = venous pooling, most common in general anesthesia and spinal cord injuries and septic shock (bacterial infection where toxins in blood). cause: general anesthesia and spinal cord injuries and septic shock
For obstructed airways, abdominal thrusts are not permitted in children of what age group? Less than 1 year old 1 to 3 years old 1 to 8 years old 6 to 12 years old
less than 1 year old
At the scene of a mass-casualty incident, you identify a patient as an organ donor. When triaging the other patients, you:
may have to assign the donor patient a lower triage priority
You are caring for a 40-year-old female who was involved in a motor vehicle crash. Her husband, who was driving the vehicle, was killed. When the patient asks you if her husband is all right, you should:
let clergy or hospital staff relay the bad news if possible.
mid axillary
line drawn veritcally from the middle of the armpit to the ankle
esophagitis
lining of esophagus inflamed by infection or from stomach acid. pain swallowing, feeling like something is stuck in throat. heartburn, nausea, vomiting, sores in mouth. bleeding possible
Protocols
lists of steps, such as assessments and interventions, to be taken in different situations. Protocols are developed by the Medical Director of an EMS system
right upper quadrant
liver, gallbladder, part of colon, pancreas
Atrioventricular node
located in the lower wall of the right atrium; delays impulses from the SA node to allow the atria to completely empty before the ventricles contract
Sinoartrial node
located in the upper portion of the "R" atrium. Has its own rhythm. Sets the basic pace for the cardiac rate.
Which of the following is not considered to be protected health information(PHI)?
location of the call
hypovolemic shock cause
loss of blood or fluid
Hyperglycemia symptoms
lots of eating, peeing, drinking. blurred vision, fatigue, weight loss
do not use CPAP when
low BP, signs/symptoms of pneumothorax, respiratory arrest, chest trauma, tracheostomy, decreased level of consciousness, gastrointestinal bleeding
cystitis (inflammation of bladder)
lower midabdomen (retropubic) pain
In which of the following positions would it be least likely that you would find an adult patient with difficulty breathing? standing sitting straight up sitting up, leaning forward on the arms lying down
lying down
flexible stretcher
made of canvas or rubberized or other flexible material, often with wooden slats sewn into pockets and three carrying handles on each side. can be useful in restricted areas or narrow hallways
You are dispatched to the scene of a crash involving a large tanker truck. While you are en route, dispatch advises you that there are multiple patients and that the fire department is en route as well. As you approach the scene, you should:
maintain a safe distance and try to read the placard with binoculars
Continuing education in EMS serves to..?
maintain, update and expand your knowledge and skills
You are summoned to a convalescent center for an 88-year-old female with an altered mental status. A staff nurse advises you that the patient has terminal cancer and her physician stated that she would probably die within the next few hours; a valid do not resuscitate (DNR) order is presented to you. When caring for this patient, you should:
make her comfortable and provide emotional support.
At the scene of an automobile crash, a utility pole has been broken, and power lines are lying across the car. The patients inside the car are conscious. You should:
mark off a danger zone around the downed lines.
Sputum
material expelled from the lungs by coughing
Which of the following best explains the reason for giving oxygen to a patient complaining of chest pain? relief of pain decrease the patient's anxiety maximize oxygenation of the heart muscle relieve nausea and prevent vomiting
maximize oxygenation of the heart muscle
You performed an initial assessment and determined that your patient has a significant mechanism of injury. Which of the following should be performed next? SAMPLE history detailed physical exam rapid trauma assessment focused history and physical exam
rapid trauma assessment
hypovolemic shock signs/symptoms
rapid/weak pulse, low BP, change in mental status, cyanosis, cool/clammy skin, increased respiratory rate
When caring for a 65-year-old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patient's condition continues to deteriorate and he develops cardiac arrest and dies at the hospital. This scenario is an example of:
negligence
Which of the following is typically the earliest indication of shock (hypoperfusion) due to blood loss? nervousness and agitation loss of consciousness drop in blood pressure slow pulse rate
nervousness and agitation
bicarbonate
neutralizes stomach acid in the duodenum
epidemic
new cases of a disease occur in a human population and substantially exceed what is expected based on recent experience
spleen
no digestive function; lymphatic system- filtration of blood, development of RBC, blood reservoir, produces antibodies
ibuprofen/advil, motrin, nuprin
nonsteroidal anti-inflammatory/fever for mild pain/fever/headache/muscle aches don't take if: hypersensitivity causes: nausea, vomiting, stomach pain, bleeding, allergic rxn (200-400 mg/4-6 hours)
Maintaining the chain of evidence at the scene of a crime should include:
not cutting through holes in clothing that were caused by weapons
wheezing breath sounds
obstruction of lower airway
Chronic bronchitis
obstructive pulmonary disease characterized by excessive production of mucus and chronic inflammatory changes in the bronchi, resulting in a cough with expectoration for at least 3 months of the year for more than 2 consecutive years.
Emphysema
obstructive pulmonary disease characterized by overexpansion of the alveoli with air, with destructive changes in their walls resulting in loss of lung elasticity and gas exchange
Antepartum
occurring or existing before birth
Acute pulmonary edema
occurs when an excessive amount of fluid collects in the spaces between the alveoli and capillaries, disturbs normal gas exchange
standing orders issued by the medical director that allow EMTs to do things without speaking to the med director
off-line medical direction
According to Occupational Safety and Health Administration (OSHA) regulations, an employer must:
offer a workplace environment that reduces the risk for exposure..
Prescription glasses do not provide adequate eye protection because they:
offer little or no side protection.
What type of medical direction do standing orders and protocols describe?
offline
COPD
often from cigarette smoking, reduced elasticity of lungs (emphysema) or irritation of bronchi and trachea (chronic bronchitis) *chronic cough, sputum,
orders from the on-duty MD given directly to an EMT-B
on-line medical direction
Splinting a closed, angulated fracture in the position in which it was found may cause a(n) _______ during transport.
open fracture
contralateral
opposite side
pandemic
outbreak that occurs on a global scale
hernia
pain anywhere in abdominal area; if non-reducible it can stop blood supply (strangulation)
dissecting aneurysm vs AMI
pain from AMI is often preceded by nausea, indigestion, weakness and sweating and tends to come on gradually, getting more severe over time. usually described as pressure instead of stabbing. Dissecting aortic aneurysm comes on full force suddenly
diverticulitis
pain in left lower quadrant
abdominal aortic aneurysm (ruptured or dissecting)
pain in low part of back and lower quadrants
kidney stone
pain in right or left flank, radiating to genitalia
pancreatitis
pain in upper abdomen (both quadrants) and back, nausea, vomiting, abdominal distention and tenderness caused by obstructing gallstone, alcohol abuse, etc.
peptic ulcer
pain in upper midabdomen or upper part of back, less pain after eating, nausea, vomiting, belching, heartburn (open sore in the lining of the stomach or duodenum)
polyuria
painful and frequent urination
What part of the body can be used to estimate 1% surface area
palm
Insulin is produced in the islets of Langerhans of which organ?
pancreas
The source of insulin in the human body is the:
pancreas
Which solid organ manufactures white blood cells?
pancreas
ileus
paralysis of the muscular contractions that normally propel material through the intestine (causes abdominal distention, and only emesis can empty stomach)
An EMS provider who has extensive training in various aspects of advanced life support is called a...
paramedic
Cardiac monitoring, pharmacological interventions, and other advanced treatment skills are functions of the...?
paramedic
use continuous positive airway pressure (CPAP) when
patient has moderate-severe respiratory distress, is alert and able to follow commands, is breathing at a rate of more than 26 breaths/min or has a pulse oximetry reading of less than 90%
Manual immobilization must be maintained in the spine-injured patient until which of the following is accomplished? Cervical collar is in place patient is placed on the backboard head blocks are in place patient is completely secured to the spine board
patient is completely secured to the spine board
According to the Nation EMS Scope of Practice Model, an EMT would require special permission from the medical director and the state EMS office in order to ...
perform blood glucose monitoring
After delivering your first shock with an AED, the patient is still pulseless, you should next
perform two minutes or 5 cycles of CPR
The condition where an injury has caused blood to accumulate in the sack surrounding the heart, impairing its ability to pump, is which of the following? Pneumothorax Tension Pneumothorax pericardial tamponade sucking chest wound
pericardial tamponade
Physiologic manifestations of stress include:
perspiration, increased blood glucose levels, and dilated pupils.
Subdural hematoma
pertaining to below the dura mater, tumor of blood
epilepsy drugs
phenytoin (dilantin), phenobarbital, carbamazepine (tegretol)
Placenta stage
placenta is expelled-afterbirth
Which of the following components of the blood is responsible for initially stopping bleeding? Platelets Plasma White blood cells red blood cells
platelets
Your patient's skin appears blue. You should presume this to be an indication of
poor oxygenation
cardiogenic shock treatment
position comfortably, administer oxygen, assist ventilations and transport
respiratory insufficiency shock signs/symptoms
rapid/weak pulse, low BP, change in mental status, cyanosis, cool/clammy skin, increased respiratory rate
Pertinant characteristics of breathing
rate, rhythm, quality, depth
delayed stress reactions
reaction to stress that occurs after a stressful situation
acute stress reactions
reaction to stress that occurs during a stressful situation
pancreas
regulate glucose metabolism (insulin)
neurogenic shock treatment
secure airway, stabilize spine, ventilations, oxygen, transport, preserve body heat
Placenta previa
pregnancy in which the placenta is implanted in the lower part of the uterus (instead of the upper part)
Ectopic pregnancy
pregnancy resulting from gestation elsewhere than in the uterus
afterload
pressure to be overcome when left ventricle contracts (pressure within the aorta)
You are treating a man with a closed head injury following an assault by a burglar. The patient, who has slurred speech, becomes verbally abusive and tells you to leave him alone. You should:
proceed with treatment and utilize law enforcement if necessary
Not all poisons are toxins. Toxins are poisons that are
produced by living organisms
tension pneumothorax
progressive shortness of breath, increasing altered level of consciousness, neck vein distension, tracheal deviation
The criteria to be licensed and employed as an EMT include...?
proof of immunization against certain communicable diseases
What section of the Health Insurance Portability and Accountability Act(HIPAA) most affects EMS personnel?
protecting patient prvacy
list of steps to be taken in different situations
protocols
To minimize the risk of litigation, the EMT should always:
provide competent care the meets current standards
You and your partner are the first to arrive at a potential crime scene with a critical injured patient involved. The scene is safe. Your first priority is to:
provide immediate patient care
You are dispatched to a middle school for a 16-year-old female experiencing an asthma attack. She is conscious and alert, but in severe respiratory distress. The school nurse informs you that she has tried several times to contact the patient's parents but has not been successful. You should:
provide treatment up to your level of training and transport the child at once
A unique function of the emergency medical dispatcher (EMD) is..?
providing callers with life-saving instructions
A sign of breathing difficulty in children is a decrease in ___ ___.
pulse rate
Pea
pulseless electrical activity. Heart is doing something but not pumping
An example of a shockable rhythm
pulseless ventricular tachycardia
right side of heart
pumps deoxygenated blood to the lungs (low pressure)
left side of heart
pumps oxygenated blood throughout the body (high pressure pump)
When treating a patient who is trapped in a vehicle and covered with broken glass, it is BEST to wear:
puncture-proof leather gloves over your latex gloves.
PERRL
pupils, equal, round, regular in size, react to light
Upon arriving at the scene of a motor vehicle crash, you note that two small cars collided head-on; the occupants are still in their vehicles. The fire department is in the process of stabilizing the vehicles and law enforcement personnel are directing traffic. After parking the ambulance at a safe distance, you and your partner should:
put on high-visibility safety vests..
You are dispatched to an apartment complex for a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should:
quickly move the coffee table so you can access and treat the patient
In patients > 1 y/o, the 1st pulse you check
radial
The first place the EMT should check for the pulse of most adult patients is at the ___ artery
radial if conscious, carotid if unconscious
ventricular tachycardia
rapid heart rhythm (150-200 bpm) that starts in ventricle instead of atrium
hypoglycemia signs/symptoms
rapid onset, pale/cool/moist skin, very hungry, normal or rapid respirations, normal to low BP, rapid/weak pulse, irritable, confused, seizures and coma, respond immediately to treatment
psychogenic shock signs/symptoms
rapid pulse, normal/low BP
liver
secretes bile, filters toxic subs produced by digestion, creates glucose stores and produces subs necessary for blood clotting and immune function
hypovolemic shock treatment
secure airway, assist ventilations, oxygen, control bleeding, consider elevating legs, keep warm, transport
respiratory insufficiency shock treatment
secure airway, clear air passages, assist ventilations, administer high-flow oxygen, transport promptly
You have been working at the scene of a major building collapse for 8 hours. Many injured people are still being removed, and everyone is becoming frustrated and losing focus. This situation is MOST effectively managed by:
requesting a CISM team to provide on-scene peer support
Quid pro quo, a type of sexual harassment, occurs when the harasser:
requests sexual favors in exchange for something else.
gallbladder
reservoir and concentrating organ for bile produced by liver
You approach a patient who appears to be unconscious. The patient does not open his eyes when you speak to him, but tries to push your hand away when you pinch his shoulder. The patient's level of responsiveness is best described as:
responsive to painful stimuli
pulmonary edema
result of congestive heart failure (left side of heart can't pump oxygenated blood out from lungs as quickly as right side delivers it) Fluid buildup = not enough space for deep breaths *also caused by poisonings
A 75-year-old male with a terminal illness has died at home. As you and your partner enter the residence, a family member becomes verbally abusive, pushes you, and states that you took too long to get there. You should:
retreat and notify law enforcement personnel.
Lung sounds that resemble low-pitched snoring or rattling are called
rhonchi
peristalsis
rhythmic movement that moves waste matter through the intestines
appendicitis
right lower quadrant pain, around navel, rebounding pain (after palpation), anorexia, fever, nausea, vomiting, chills
. With regard to SAMPLE history: Seeing the fractured end of a bone sticking through the skin relates to which letter of the mnemonic?
s
midsagittal plane
sagittal plane that is exactly midline
Dermis
second layer of skin, holding blood vessels, nerve endings, sweat glands, and hair follicles
tonic phase
seconds of constant muscle contraction, trembling, tongue biting, bladder/bowel incontinence
Acute coronary syndrome
sudden symptoms of insufficient blood supply to the heart, sudden symptoms of insufficient blood supply to the heart indicating unstable angina or myocardial infarction
Acute abdomen
sudden, sever abdominal pain that is less than 24 hours in duration
You arrive at the scene of a domestic violence situation. As you approach the doorway of the apartment, you hear screaming and the statement "He has a gun!" Your MOST appropriate action should be to:
seek a safe place and request law enforcement assistance..
septic shock cause
severe bacterial infection
respiratory insufficiency shock cause
severe chest injury, airway obstruction
Patients who become dependent upon EMS personnel or other health care providers often feel:
shamed
pulmonary embolus
sharp/pinpoint pain, dyspnea, sudden onset (after childbirth or surgery)
Hypovolemic shock
shock caused by severe blood or fluid loss
Cardiogenic shock
shock that results from failure of the heart in its pumping action.
Acute Stress
short term ; fight or flight response ; effects disappear quickly after it is over
abdominal aortic aneurysm
slowly develops, if tears or ruptures will cause massive bleeding, "tearing" back pain
dysarthria
slurred speech
platelets
smaller than blood cells, essential in initial formation of blood clots
The manner in which the EMT must act or behave when caring for a patient is called the:
standard of care
a policy or protocol issued by a medical director that authorizes EMTs to perform particular skills in certain situations
standing orders
The standards for prehospital emergency care and the individuals who provide it are typically regulated by the ...
state office of EMS
phrenic nerve
stimulates the diaphragm
Luq
stomach spleen left lobe of liver body of pancreas L kidney and
left upper quadrant
stomach, spleen, part of colon, pancreas
liver
storage of sugar or starch, aid in immune response
Partial upper airway obstruction is indicated by which examination finding? Stridor on inspiration Absence of breath sounds on the affected side Wheezing on exhalation Lying down
stridor on inspiration
You've arrived at the scene of a medical emergency. The family states that after diner the father began to have difficulty moving around and speaking. On exam, you find that the patient has slurred speech and is unable to move his right arm or leg. You suspect that the patient has suffered a:
stroke
Hemorrhagic stroke
stroke caused by the rupture of a blood vessel in the brain
transient ischemic attack
stroke symptoms go away on their own in less than 24 hours (body breaks up brain blood clot)
subarachnoid hemorrages
stroke that occurs when an aneurysm is overstretched and ruptures leading to blood in the subarachnoid space
A hematoma inside the innermost layer of tissues protecting the brain is classified as which of the following? epidural subdural intracerebral subarachnoid
subarachnoid
What route refers to placing a medication under the tongue?
sublingual
The MOST serious consequence of drug or alcohol abuse among EMS personnel is:
substandard or inappropriate patient care.
When air is bubbling in an open chest, it is which type of injury? Pneumothorax tension pneumothorax pericardial tamponade sucking chest wound
sucking chest wound
symptoms of dissecting aneurysm
sudden chest pain located in anterior part of chest or in back b/t shoulder blades
pneumothorax
sudden chest pain w/ dyspnea, decreased lung sounds/affected side
If a cardiac arrest occurs within two hours of the onset of symptoms, it is called
sudden death
rupture of esophageal varices
sudden discomfort in throat, difficulty swallowing, vomiting of bright red blood, hypotension, signs of shock
Asystole
the absence of a heartbeat
When pressure increases inside the skull because of swelling of brain tissue, blood flow is decreased. This results in...
the brain being starved for oxygen and carbon dioxide increasing, causing more swelling.
Acetabulum
the cup-shaped hollow in the hipbone into which the head of the femur fits to form a ball-and-socket joint
Standard Care
the degree of care that a reasonably prudent person should exercise under the same or similar circumstances
Your patient is a 25-year-old male who was ejected from a vehicle during a high-speed collision. He is unresponsive to verbal and painful stimuli. Which of the following best describes what should be included in the detailed physical exam? head, neck, chest, back, abdomen, pelvis head, chest, abdomen, vital signs chest, abdomen, pelvis, lower extremities the entire body, from head to toe, anteriorly and posteriorly
the entire body, from head to toe, anteriorly and posteriorly
Perineum
the general region between the anus and the genital organs
semi fowler position
the head of the bed is raised 30 degrees; or the head of the bed is raised 30 degrees and the knee portion is raised 15 degrees
mid clavicular
the line through the center of the clavical
Atherosclerosis
the most common form of CVD; a disease characterized by plaques along the inner walls of the arteries.
Ischemic stroke
the most common kind of stroke
Gravida
the number of the pregnancy that a woman is in
brain stem
the part of the brain continuous with the spinal cord and comprising the medulla oblongata and pons and midbrain and parts of the hypothalamus
cricoid cartilage
the ring-shaped structure that forms the lower portion of the larynx
Coronary arteries
the two arteries that supply blood to the heart muscle
Jugular vein distention
the visible bulging of the jugular vein when the Pt is in semi-fowlers position or full fowlers position. this is indicative of inadaquate blood movement through the heart and/or lungs
Which of the following is true of oral medications taken for diabetes? they are oral forms of insulin they are taken to increase the blood sugar level they stimulate the pancreas to secrete insulin they reduce the body's need for glucose
they stimulate the pancreas to secrete insulin
scoop stretcher
this cot splits in tow or four sections, so it can be used where larger stretchers cannot fit.
Type 1
this type of diabetes mellitus is an autoimmune situation. The pancreas produces and releases NO insulin, so no glucose transport.
Your best protection against legal liability when a competent patient refuses EMS care and transport is to:
thoroughly document the entire event
the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system
thrombosis
Early or superficial cold injury is evidenced by which of the following? tingling sensation when rewarmed blisters flushed skin white waxy skin
tingling sensation when rewarmed
Hypodermis
tissue layer beneath the dermis; contains adipose tissue, a connective tissue that includes fat-storing cells and blood vessels
Once placed on the spine board, in which order should the straps be applied? torso, feet, head feet, torso, head head, torso, feet head, feet, torso
torso, feet, head.
superior
toward the head or above point of reference
The windpipe is also known as the:
trachea
lower airway
trachea, bronchi, bronchioles, and aveoli (gasses travel through the structers to and from the blood)
If you are exposed to a patient's blood or other bodily fluid, your first action should be to:
transfer care of your patient to another EMS provider.
TIA
transient ischemic attack; temporary interference with the blood supply to the brain
True or false: respiratory problems should be suspected in patients with behavioral changes
true
You suspect that a 6-year-old girl has broken her leg after falling from a swing at a playground. Shortly after you arrive, the child's mother appears and refuses to allow you to continue treatment. You should:
try to persuade the mother that treatment is needed
Thrombotic stroke
type of stroke caused by a blood clot blocking an artery in the brain
Capillary refill time is a useful indication of perfusion in patients ___ years of age
under 6
acidosis
use of fat for fuel creates ketones and fatty acid waste products
stridor
usually can be heard w/o stethoscope, indicates airway obstruction in neck or upper part of the chest
Epinephrine: Action
vasoconstriction, bronchodilation
NTG: Action
vasodilator, decreases blood return to heart
emesis
vomiting
septic shock signs/symptoms
warm skin, tachycardia, low BP
aura
warning to seizure
The simplest yet most effective method of preventing the spread of an infectious disease is to:
wash your hands in between patient contacts.
If you use a waterless handwashing substitute in the field, it is important to:
wash your hands with soap and water at the hospital.
aortic aneurysm
weakness in the wall of the aorta (susceptible to rupture)
diabetic ketoacidosis
weakness, nausea, vomiting, abdominal pain, weak/rapid pulse, kussmaul respirations
The MOST effective way to preserve your own body heat when functioning in cold, wet weather is to:
wear at least three layers of clothing..
rales
wet breath sounds that may indicate cardiac failure (crackles)
asthma
wheezing on inspiration/expiration, bronchospasm
diastole BP
when heart rests between contractions, there is still a resting blood pressure is vessels (ventricle filled w/ blood)
Critical incident stress management (CISM) can occur at an ongoing scene in all of the following circumstances, EXCEPT:
when patients are actively being assessed or treated..
Gloves, a mask, eye protection, and a face shield should be used:
when performing endotracheal intubation..
dissecting aneurysm
when the inner layers of the aorta become separated, allowing blood at high pressures to flow between the layers. (likely to be ruptured under conditions of high BP)
A positive TB skin test indicates that:
you have been exposed to the disease..
As an EMT, you may be authorized to administer aspirin to a patient with chest pain based on..
your local EMS protocols
While trying to make a family member feel better after a loved one has died, your partner uses trite statements. The family members may view this as:
your partner's attempt to diminish their grief..